OBJECTIVE: The aim of this study was to investigate the effects of extracorporeal shock wave therapy (ESWT) and dry needling (DN) combination to the trigger points in the forearm extensor muscles on pain, grip strength and functionality in patients diagnosed with lateral epicondylitis. MATERIALS AND METHODS: Forty patients who were clinically diagnosed with lateral epicondylitis were included in the study. The patients were divided into two groups as ESWT and ESWT+DN. Patients in the ESWT and exercise group were applied 2,000 pulses, once a week, three sessions; in addition to that three sessions of DN therapy was applied to the other group. Also, stretching and eccentric strengthening exercises were applied to the patients in both groups. The pain severity of the patients which occured with palpation and grip was measured by visual analog scale (VAS), lateral epicondyle sensitivity by an algometer, grip strength by dynamometer and functionality level by the patient-rated tennis elbow evaluation (PRTEE) pre-treatment and at the end of treatment (first month). RESULTS: In both groups; there were statistically significant improvements in first month VAS scores of the pre- and post-treatment (morning, activity, and rest) (p < 0.001); in the comparison of the intergroup, the improvement in pain scores, except for night pain, was found to be superior in the ESWT+DN group (p < 0.001). The evaluation of the most sensitive region of the lateral epicondylitis pre- and post-treatment with algometer were compared, there was a significant improvement in both groups (p < 0.001), whereas the improvement in ESWT+DN group was observed to be superior (p < 0.001). While the maximum grip strength values measured in the elbow flexion and extension position increased significantly in both groups after the treatment, the increase in the extension position in the ESWT+DN group was outstanding (p < 0.05). When the pre- and post-treatment changes seen in the PRTEE scale of the patients were examined; a statistically significant decrease was observed in all groups in favor of improvement post-treatment (p < 0.05). In ESWT+DN group, pain score and function score change were more effective than ESWT group (p < 0.001). CONCLUSION: These results suggest that ESWT and DN combination therapy in lateral epicondylitis provide better clinical outcomes than ESWT treatment alone.

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