Effects of Instrument-Assisted Soft Tissue Mobilization and Extracorporeal Shock Wave Therapy in Individuals With Lateral Elbow Pain: A Randomized Single-Blind Clinical Trial.

Lateral elbow pain, often called tennis elbow, is usually managed with exercise, but clinicians also use hands-on and device-based treatments like instrument-assisted soft tissue mobilization (IASTM) and extracorporeal shock wave therapy (ESWT) to try to speed recovery. This trial compared IASTM plus home exercise, ESWT plus home exercise, and home exercise alone in 48 adults, tracking pain, grip strength, and arm function immediately after treatment and again four weeks later. All three groups improved over time. However, IASTM was reported as more effective than both ESWT and exercise-alone at reducing pain and improving function and grip strength, while ESWT was more effective than exercise alone for pain.

Because the comparison groups received less therapist contact than the IASTM and ESWT groups, some of the added benefit could reflect attention or expectation rather than the techniques themselves. The small sample size also means these findings should be read as preliminary rather than conclusive.

If you have ongoing lateral elbow pain, often called tennis elbow, you may wonder whether hands-on techniques or shockwave devices add anything beyond basic stretching and strengthening exercises. This small trial of 48 adults compared three approaches: a home exercise program alone, home exercise plus a tool-assisted soft tissue technique called IASTM, and home exercise plus shockwave therapy. Everyone in the study improved in pain, grip strength, and function over time, including the exercise-only group.

But those who received IASTM alongside their exercises showed greater improvements in pain, grip strength, and function than the shockwave or exercise-only groups, both right after treatment and four weeks later. The shockwave group also did better than exercise alone for pain. Because the exercise-only group received less hands-on attention, some of the extra benefit seen with IASTM or shockwave therapy could partly reflect that added contact rather than the technique itself.

With only 48 people involved, these results are an early signal rather than firm proof, and larger studies would help confirm them.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This trial speaks to a common clinical question in managing lateral epicondylalgia: does adding a manual or device-based modality to a home exercise program (static stretching and eccentric strengthening) improve outcomes beyond exercise alone, and if so, which modality performs better? Forty-eight adults were randomized to exercise-only control, exercise plus 8 sessions of ESWT, or exercise plus 8 sessions of IASTM, with outcomes (visual analog scale pain, hydraulic dynamometer grip strength, Patient-Rated Tennis Elbow Evaluation) assessed at baseline, post-intervention, and 4-week follow-up. All groups improved significantly within-group across outcomes. Between-group comparisons favored IASTM over both ESWT and control for pain, grip strength, and functional scores at both timepoints, while ESWT outperformed control for pain.

This raises IASTM as a modality that may offer additional benefit over exercise alone in the short to medium term, though since the control group received comparatively less therapist contact without a sham condition, attention or expectation effects cannot be ruled out as contributors, particularly for the patient-rated outcomes. The abstract does not report adverse events, so no safety conclusions can be drawn. With a modest sample of 48 participants across three arms, these findings should be regarded as an initial comparison rather than definitive evidence of IASTM's superiority over ESWT in broader clinical populations.