Efficacy of extracorporeal shock wave therapy and nutraceutical supplementation in the treatment of lateral epicondylitis: a randomized controlled trial.
Dalila Scaturro, Domenico Migliorino, Sofia Tomasello and 4 others
PMID 40567345WHAT IT FOUND
Combining exercise, shock wave therapy, and supplements cut pain and disability more than either alone.
This trio was the only approach that significantly improved grip strength. Exercise plus supplements reduced pain faster, within 15 days.
Key findings
01The combined treatment group achieved statistically significant better results in pain reduction and disability compared to the other two groups.
02The combined treatment group was the only one to show a significant improvement in grip strength compared to the other two groups.
03The group receiving exercise and supplements showed significant pain improvement earlier, at 15 days, whereas the other groups did not show significant change at that time point.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was not blinded, which increases the risk of bias in subjective pain and function reporting. There was no control group that received exercise alone, so the specific contribution of the shock wave or supplement versus the exercise itself cannot be isolated. Follow-up was only 30 days, which is short given the chronic nature and high recurrence rate of lateral epicondylitis. The sample size was small (45 patients) and limited to ages 18-45, excluding older adults who may have different healing responses. Ultrasound assessment was limited to tendon thickness, missing other potential markers of tendon health like vascularity changes over time.
Declared interests
The authors declare that no financial support was received for the research or publication of this study.
The easy way to misread this
Do not assume the shock wave or supplements alone caused the improvement, as all groups received therapeutic exercise. The study lacks an exercise-only control group, so the benefit of the added treatments cannot be separated from the effect of the rehab program.