Ultrasound-Guided PRP Injection vs Dry Needling for Lateral Epicondylitis: A Randomized Controlled Trial

This study aimed to determine if ultrasound-guided platelet-rich plasma (PRP) injections provide superior outcomes to ultrasound-guided dry needling for patients with lateral epicondylitis, especially in cases involving common extensor tendon tears. Conducted as a single-center, single-blind, randomized controlled trial from November 2018 to April 2020, the study included 40 patients diagnosed with lateral epicondylitis, who were symptomatic for at least three months and met specific sonographic criteria. Participants were divided into two groups (PRP and dry needling), with exclusion criteria including complete tendon tears or concurrent shoulder or elbow conditions, such as osteoarthritis. Results demonstrated that the PRP group showed significant improvements in pain, as measured by the visual analogue scale, at nine months post-treatment compared to the dry needling group, though no notable differences were observed at three or six months. PRP treatment also resulted in slightly better improvements in tendon thickness at both three (5.1 mm) and six months (4.3 mm) compared to dry needling (4.4 mm and 4.0 mm, respectively). Although no difference in tendon tear healing was observed at three months, by six months, the PRP group showed significantly better healing (mean of 2.5) than the dry needling group (mean of 3.1). These findings suggest that two ultrasound-guided PRP injections may offer more effective, non-surgical management of lateral epicondylitis than dry needling, particularly for improving pain, tendon thickness, and tear healing over time.