The goal of this randomized controlled trial is to compare the effects of shockwave therapy and eccentric exercises on pain, functional ability, quality of life, grip strength and range of motion in patients with lateral epicondylitis. Participants will be randomly assigned to either Group A (Shockwave therapy) or Group B (Eccentric Exercises) using a computer-generated random number tables method.

The intervention will be provided over five weeks, with three sessions per week (total of 15 sessions):

Group A (Shockwave therapy): Participants will receive shockwave therapy, for 5 min with energy level 7.0 m J and frequency 6 Hz.

Group B (Eccentric Exercises): Participants will receive eccentric exercises, repeating each 10 repetitions 3 sets per session with a 1 min rest between each of them.

Outcomes will be assessed at baseline, week 0 and week 5 to evaluate which exercise program is more effective in reducing symptoms and improving functional outcomes.

Inclusion Criteria:

• Patients diagnosed with Lateral epicondylitis
• Patients with 20-50 years
• Both males and females
• Willing to participate and provide informed consent

Exclusion Criteria:

• Patients with recent trauma (fractures, injury etc.)
• Patients with blood clotting disorder (including thrombosis), oral anti-coagulants, and pacemaker, tumors at site of treatment, infected area or skin rupture or abrasion at the site of treatment, pregnancy.
• Cervical Radiculopathy or any diseases that mimic or refer pain to elbow.
• Patients who received steroid injection within 6 weeks.

Participants will be informed that both interventions are effective physiotherapy treatments for lateral epicondylitis but will not be told which group they belonged to. The outcome assessor will remain blinded to group allocation throughout data collection at baseline and week 5.

To maintain blinding, participants will be instructed not to disclose their exercise details during assessment, and all data will be recorded using coded identifiers (Group A or B).