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Efficacy of extracorporeal shock wave therapy and nutraceutical supplementation in the treatment of lateral epicondylitis: a randomized controlled trial

Summary

This study tested three different treatment approaches for tennis elbow (pain in the outer elbow), a common condition affecting the forearm muscles. The treatments included shock wave therapy, a dietary supplement containing collagen and hyaluronic acid, and therapeutic exercises. The results showed that combining all three treatments was most effective, providing the best pain relief, functional improvement, and grip strength recovery within 30 days. The findings suggest that combining different treatment approaches may work better together than using them separately.

Background

Lateral epicondylitis (tennis elbow) is a common tendinopathy affecting the forearm extensor muscles, characterized by pain and functional limitation. While the natural course is generally favorable, recurrence and chronicity have significant functional and economic implications. Multiple treatment options exist, but their optimal combination remains unclear.

Objective

To evaluate the efficacy of focal extracorporeal shock wave therapy (ESWT) combined with nutraceutical supplementation (hyaluronic acid, collagen, vitamin C, and manganese) compared with single treatments in patients with lateral epicondylitis, measuring improvements in pain, functional capacity, muscle strength, and inflammation.

Results

NRS scores decreased significantly in all groups at T2, with Group B showing earlier pain reduction at T1. Grip strength increased significantly only in Group C at T2. PRTEE scores and CET thickness improved significantly in all groups at T2. Group C demonstrated statistically superior improvements in function and grip strength compared to other groups.

Conclusion

Combined treatment with ESWT, therapeutic exercise, and nutraceutical supplementation demonstrates synergistic effects superior to single treatments, offering viable management for lateral epicondylitis with significant pain relief, functional recovery, and reduction in inflammatory state in the short term.
  • Published in:Frontiers in Rehabilitation Sciences,
  • Study Type:Randomized Controlled Trial,
  • Source: PMID: 40567345, DOI: 10.3389/fresc.2025.1593909
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