Therapeutic ultrasound versus acupuncture for lateral epicondylitis: a pilot case-control observational study

BACKGROUND: Lateral epicondylitis, commonly known as tennis elbow, is a prevalent musculoskeletal condition characterized by pain and functional impairment of the lateral elbow. Among conservative treatments, both acupuncture and therapeutic ultrasound are widely used, yet their comparative effectiveness remains unclear. This study aimed to evaluate the clinical outcomes of manual and electroacupuncture versus therapeutic ultrasound in patients with chronic lateral epicondylitis. METHODS: This pilot case-control study included 30 outpatients with chronic lateral epicondylitis, divided into two groups: one treated with a combination of manual acupuncture and electroacupuncture, and the other with therapeutic ultrasound. Each group received 10 treatment sessions over two weeks. Outcomes were assessed at baseline, immediately post-treatment, and at 2-and 4-weeks follow-up. The primary outcome was pain intensity measured by the Visual Analogue Scale. Secondary outcomes included functional disability (Disabilities of the Arm, Shoulder and Hand questionnaire and Patient-Rated Tennis Elbow Evaluation), grip strength, and quality of life (EuroQol-5D). Between-group comparisons were performed using the Mann-Whitney U Test. RESULTS: Both treatments led to improvements in pain and function. However, the acupuncture group showed greater reductions in pain intensity and superior gains in grip strength, particularly at short-term follow-up. No adverse events were reported in either group. CONCLUSIONS: Acupuncture, combining manual and electroacupuncture, appears to be more effective than therapeutic ultrasound in reducing pain and improving grip strength in patients with chronic lateral epicondylitis. These findings support its use as a safe and effective conservative treatment option.