{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:45:41Z","timestamp":1782456341833,"version":"3.54.5"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Lateral epicondylitis (LE) is a prevalent chronic tendinopathy that significantly impairs upper limb function and quality of life. This network meta-analysis (\n                      <jats:italic>N<\/jats:italic>\n                      MA) aims to evaluate and compare the short-term (\u22643 months) efficacy of various micro-invasive and physical interventions for pain relief and functional restoration, providing an evidence-based framework for tailored clinical decision-making.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search was performed in PubMed, Embase, the Cochrane Library, Web of Science, and CNKI for randomized controlled trials (RCTs) investigating physical interventions for LE. Primary outcomes included the Visual Analogue Scale (VAS), the Disabilities of the Arm, Shoulder and Hand (DASH) score, and the Patient-Rated Tennis Elbow Evaluation (PRTEE). Data synthesis, consistency testing, and Surface Under the Cumulative Ranking curve (SUCRA) calculations were performed using Stata 18.0. Two-dimensional cluster analysis was employed to concurrently assess the analgesic and functional benefits of the interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Analysis of 38 RCTs revealed that percutaneous electrolysis (PE) was the most effective intervention for pain reduction (SUCRA\u2009=\u200998.5%), yielding a clinically pronounced effect size against baseline care (MD\u2009=\u2009\u22126.00, 95% CI: \u22129.75 to \u22122.25) and outperforming most other physical therapies. Dry needling (DN) demonstrated the highest ranking probability in functional improvement (DASH SUCRA\u2009=\u200979.7%; PRTEE SUCRA\u2009=\u200985.2%), and was the sole active treatment significantly superior to conservative care on the PRTEE scale (MD\u2009=\u2009\u221225.04, 95% CI: \u221248.29 to \u22121.79). In the cluster analysis, PE was localized to the \u201cstrong analgesia\u201d quadrant, while DN was situated in the \u201cstrong functional recovery\u201d quadrant. Other interventions, such as platelet-rich plasma and corticosteroid injections, exhibited only moderate effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The investigated interventions yield distinct therapeutic profiles for LE within an early temporal window. Percutaneous electrolysis shows the highest probability for rapid pain mitigation, whereas dry needling presents a favorable probability profile for restoring localized elbow function. However, given the high underlying network heterogeneity, the lack of statistical significance in DASH-related pairwise comparisons, and overlapping prediction intervals, these SUCRA-based rankings should be interpreted cautiously. We do not recommend formulating definitive long-term clinical recommendations based on these early temporal profiles; instead, clinical decisions should be tailored to the patient's predominant short-term symptoms\u2014balancing immediate pain relief with early targeted functional recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero<\/jats:ext-link>\n                      , PROSPERO CRD420251234552.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpain.2026.1855508","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:45:48Z","timestamp":1782452748000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Short-term efficacy of physical interventions for lateral epicondylitis: a network meta-analysis based on multidimensional evaluation of pain and function"],"prefix":"10.3389","volume":"7","author":[{"given":"Yu-Hong","family":"Song","sequence":"first","affiliation":[{"name":"Martial Arts Academy, Wuhan Sports University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Yan","family":"Lan","sequence":"additional","affiliation":[{"name":"Martial Arts Academy, Wuhan Sports University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He-Hui","family":"Fu","sequence":"additional","affiliation":[{"name":"Martial Arts Academy, Wuhan Sports University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Xu","family":"Tang","sequence":"additional","affiliation":[{"name":"Martial Arts Academy, Wuhan Sports University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1177\/1758573218797973","article-title":"Tennis elbow","volume":"11","author":"Keijsers","year":"2019","journal-title":"Shoulder Elbow"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4385","DOI":"10.1097\/MS9.0000000000001115","article-title":"Platelet-rich plasma versus corticosteroid: a randomized controlled trial on tennis elbow patients resistant to nonsurgical treatments","volume":"85","author":"Sayadi","year":"2023","journal-title":"Ann Med Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2646","DOI":"10.1177\/03635465231213087","article-title":"Platelet-rich plasma has better results for long-term functional improvement and pain relief for lateral epicondylitis: a systematic review and meta-analysis of randomized controlled trials","volume":"52","author":"Xu","year":"2024","journal-title":"Am J Sports Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1578","DOI":"10.1007\/s43465-022-00649-w","article-title":"Outcomes of continued intensive conservative treatment versus arthroscopic extensor carpi radialis brevis release for recalcitrant lateral epicondylitis: a non-randomized controlled trial","volume":"56","author":"Goyal","year":"2022","journal-title":"Indian J Orthop"},{"key":"B5","doi-asserted-by":"publisher","first-page":"40","DOI":"10.5397\/cise.2024.00801","article-title":"Platelet rich plasma versus corticosteroids for lateral epicondylitis: a meta-analysis of randomized clinical trials","volume":"28","author":"Maroun","year":"2025","journal-title":"Clin Shoulder Elb"},{"key":"B6","doi-asserted-by":"publisher","first-page":"31","DOI":"10.24425\/fmc.2023.147213","article-title":"Treatment options for tennis elbow\u2014an umbrella review","volume":"63","author":"Bonczar","year":"2023","journal-title":"Folia Med Cracov"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e47706","DOI":"10.7759\/cureus.47706","article-title":"A review of physiotherapy techniques used in the treatment of tennis elbow","volume":"15","author":"Pathan","year":"2023","journal-title":"Cureus"},{"key":"B8","doi-asserted-by":"publisher","first-page":"447","DOI":"10.3390\/medicina55080447","article-title":"Tendinopathy: pathophysiology, therapeutic options, and role of nutraceutics. 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