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The primary outcome was short\u2010term (\u22643 months) and medium\u2010term (&gt;3 months but \u226412 months) pain, while the secondary outcomes were grip strength and patient\u2010reported outcome measures. All outcomes were assessed using standardized mean differences (SMDs) with 95% con\ufb01dence intervals (CIs) and were ranked using surface under the cumulative ranking curve (SUCRA) probabilities to determine a hierarchy of treatments. Sensitivity analysis was performed to eliminate potential therapeutic effects of normal saline (NS) and exclude trials that included patients with acute lateral epicondylitis (LE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>40 RCTs were included to evaluate ESWT and five different injection therapies, including corticosteroids (CSs), autologous whole blood, platelet\u2010rich plasma (PRP), botulinum toxin A (BoNT\u2010A), and dextrose prolotherapy (DPT). DPT (\u2212.78 [\u22121.34 to\u00a0\u2212.21]), ESWT (.57 [\u2212.89 to\u00a0\u2212.25]), PRP (\u2212.48 [\u2212.85 to\u00a0\u2212.11]), and BoNT\u2010A (\u2212.43 [\u2212.84 to\u00a0\u2212.02]) outperformed placebo for short\u2010term pain relief; ESWT (\u2212.44 [\u2212.85 to\u00a0\u2212.04]) outperformed placebo for medium\u2010term pain relief. DPT was ranked as the most optimal short\u2010term and medium\u2010term pain reliever (SUCRA, 87.3% and 98.6%, respectively). ESWT was ranked as the most optimal short\u2010term and medium\u2010term grip strength recovery (SUCRA; 79.4% and 86.4%, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DPT and ESWT were the best two treatment options for pain control and ESWT was the best treatment option for grip strength recovery. CSs were not recommended for the treatment of LE. More evidence is required to confirm the superiority in pain control of DPT among all these treatment options on LE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, meta\u2010analysis of Level I randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2022.01.025","type":"journal-article","created":{"date-parts":[[2022,1,30]],"date-time":"2022-01-30T21:01:57Z","timestamp":1643576517000},"page":"2018","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":38,"title":["Extracorporeal Shock Wave Therapy Shows Superiority Over Injections for Pain Relief and Grip Strength Recovery in Lateral Epicondylitis: A Systematic Review and Network 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Kaohsiung Municipal Siaogang Hospital Kaohsiung Taiwan"},{"name":"Department of Orthopedic Surgery Kaohsiung Medical University Hospital Kaohsiung Taiwan"},{"name":"Regeneration Medicine and Cell Therapy Research Center Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun\u2010Che","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Kaohsiung Medical University Hospital Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying\u2010Chun","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Post\u2010Baccalaureate Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung 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