Comparative Study for the Optimal Treatment Method of Lateral Epicondylosis

Inclusion Criteria: * 35 to 80 years of age * history of elbow pain in the region of the lateral epicondyle for more than 6 months * more than 3 months of treatment for lateral epicondylosis before enrollment in the study with no subjective improvement * pain on resisted extension of wrist * local tenderness to palpation at the lateral epicondyle * confirmed as lateral epicondylosis on ultrasound imaging Exclusion Criteria: * history of steroid or botulinum injection(s) within 6 months before study enrollment * other elbow pathology including nerve compression, previous elbow fracture, limited elbow range of motion, abnormal simple radiographic findings, history of elbow surgery and inflammatory arthropathies * upper extremity pain or discomforts from shoulder or wrist or hand