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@#Introduction: Lateral epicondylitis is a common condition causing severe incapacitating pain. Several methods of treatment have been approached for its management. In our study we aim to compare the results of injecting steroid and lignocaine mixture via single injection and peppered injection technique and analyse the outcome in each category. Materials and methods: A prospective randomised study comprising of 25 patients in each group (single vs peppered group) were included in the study after satisfying inclusion and exclusion criteria. Outcome of the treatment was measured in the form of Patient Related Tennis Elbow Evaluation (PRTEE) Questionnaire, Visual analogue score (VAS) and tenderness grading at two weeks, six weeks and six months after injection. Results: Results of our study showed that the mean PRTEE score was 22.36, 18.40 and 14.16 at 2 weeks, 6 weeks and 6 months following peppered injection as compared to 28.96, 21.84 and 25.32 in the single injection group (p value <0.05). VAS score at 2 weeks, 6 weeks and 6 months after the peppered injection was found to be 2.72, 1.72 and 1.36 and in the single injection group was 2.96, 1.92 and 2.72 at 2weeks, 6 weeks and 6 months, respectively (p value <0.05). On comparison of the 2 groups, there was a significant reduction of VAS scores at 6 months post-injection (p value <0.05) and PRTEE score at 6 weeks, 6 months in peppered injection group. Conclusion: The effects of peppered injection technique is seen to be advantageous over the single injection technique in the management of chronic lateral epicondylitis.
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Background:Platelet-rich plasma helps in repair because of its growth factor. Platelet-rich plasma has been used in humans for its healing properties. Increased concentration of growth factors and secretory proteins may increase the process of healing on a cellular level.Aim:This study was done to check the effectiveness of PRP injections in patients with chronic lateral epicondylitis.Methodology:This was accomplished in patients visiting the orthopaedic OPD at the Sree Balaji Medical College and Hospital, Chennai, Tamilnadu. There were 40 physicians in this study, among whom 37were homosexual and 87were female. The mean age of the patients was 48.1 years (17-82 years). The study period was 3 months. The analytical method used is a visual analog score.Results:Effective therapy was performed with a decline of more than 20% (24 out of 40 patients) in visual analog score after a dual-month period. After 3 months in boys, the mean VAS score dropped from 6.88 to 9.41.Conclusion:Medication of PRP patients with chronic epicondylitis or PRP tennis elbow reduces pain and increases the flexibility of the affected knee joint
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Background: Lateral Epicondylitis is the tendinosis of the extensor musculature of the forearm that has their common origin from the lateral epicondyle of the humerus due to angioblastic degeneration. The study aimed to determine and compare the effectiveness of MET and MaRhyThe in individuals with chronic lateral epicondylitis concerning pain, grip strength, and function. Methods: The study was a randomized clinical trial with 30 subjects divided into two equal groups, with 15 subjects in each group. Group A received MET for seven sessions, and Group B received MaRhyThe for one session. Both the groups received hot moist pack and conventional exercises for seven sessions. Visual Analogue Scale (VAS), Patient Rated Tennis Elbow Evaluation (PRTEE) Questionnaire, and Pain-Free Grip Strength (PFGS) were taken as the outcome measures. Results: Within-group paired sample t-test showed statistical significance in VAS at rest, VAS on activity, PRTEE, and PFGS with a p-value of 0.001 for all. However, between-group analysis using independent sample t-test showed statistical significance in VAS on activity and PRTEE with a p-value of 0.049 and 0.029, respectively, and clinical significance for VAS at rest and PFGS for Group B. Conclusion: The study concludes that both MET and MaRhyThe are effective in treating chronic LE concerning pain, improving function, and strength. However, MaRhyThe is more effective in pain reduction and improving functional activities.
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Lateral epicondylitis (tennis elbow) is a common and often extremely painful musculoskeletal condition. Several non-operative interventions with varying success rates have been described. Systematic reviews suggest that there is no clear and effective cure for pain symptoms in the first six weeks of treatment. There is a strong need for an intervention which is appropriate for patients and ensures effective short-term pain relief without increasing the risk of recurrence. The electrical stimulation using galvanic current is seen to be safe and effective in reducing pain, improving grip strength and promoting functional activities in the treatment of lateral epicondylitis.METHODSFifteen patients with lateral epicondylitis were selected. Electrical stimulation using galvanic current was applied for a period of 30 seconds at each point 3 times for 10 days. Pain, pain-free grip strength and functional status were measured using the Numerical Pain Rating Scale (NPRS), hand dynamometer and Patient Specific Functional Scale (PSFS). Measurements were taken before and after treatment. Data was subjected to statistical analysis.RESULTSMean improvement was observed for pain (NPRS), pain free grip strength and functional status (PSFS) (5.8±0.9, P=0.001), (32.6±2.6, P=0.001) and (5.2±1.7, P=0.001) respectively.CONCLUSIONSApplication of electrical stimulation using galvanic current was effective in reducing pain, improving grip strength and functional status in patients with lateral epicondylitis
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Objective: To compare the effectiveness of steroid therapy with and without physiotherapy for the management of lateral epicondylitis (tennis elbow). Methodology: Patients, who fulfil the inclusion criteria of selection were admitted to study in the Department of Physiotherapy PSRD, Lahore. Each patient received an informed consent. Demographic data including name, age, sex, height and weight were noted. Participating individuals were randomly allocated into two groups by lottery method. Patients of group A were treated by steroidal therapy without physiotherapy manoeuvres and the individuals of group B were treated by combination of steroidal therapy and physiotherapy. The follow-up was carried out for up to 4 weeks.All the information has been collected with pre-defined preforms.Data was interpreted and analysed through SPSS version 22.0. Results: The overall mean age of cases was 38.90±6.97 years and 42.07±7.03 years. There were 38(63.33%) male and 22(36.67%) female in this study. Before treatment the mean pain of participating individuals of group-A and in group-B was 7.40±1.45 and 7.63±1.27 with insignificant difference. After treatment the mean pain in group-A and group-B was 3.40±1.73 and 2.53±1.57 with significantly lower pain in group-B, p-value < 0.05. When we compared mean pain before and after injection was significantly improved in both groups but the improvement was higher in group-B. The mean pain difference in group-A and group-B was 3.77±2.18 and 4.90±1.83 with higher improvement in group-A, p-value < 0.05. Conclusion: Results of study concludesteroid injection with addition to physiotherapy was more effective in reducing pain.We must encourage orthopedic and physiotherapist teamwork to treat tennis elbow.
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BACKGROUND: Acupuncture therapy plays a very important role in the treatment of lateral epicondylitis. However, due to the diverse characteristics of acupuncture therapy, the current research mostly focuses on a simple comparison between acupuncture therapy and conventional blocking therapy. OBJECTIVE: To compare the efficacy and visual analogue scale score of different acupuncture therapies for lateral epicondylitis using a Bayesian network meta-analysis. METHODS: Randomized controlled trials on acupuncture therapy for lateral epicondylitis included in PubMed, The Cochrane Library, CNKI, VIP, and WanFang were searched. The search time was from inception until October 2019 in each database. Two researchers independently screened and extracted data according to the inclusion criteria, and then evaluated the quality of the literature. Direct meta-analysis and network meta-analysis of data were performed using ADDIS 1.16.8 software. RESULTS AND CONCLUSION: A total of 2 318 lateral epicondylitis patients were included in 32 randomized controlled trials/controlled clinical trials, concerning 6 treatment measures, including warming needle, fire needle, electroacupuncture, filiform needle acupuncture, Fu’s acupuncture, fire needle plus filiform needle. Network meta-analysis results show that: in terms of efficiency, warming needles are better than electroacupuncture, warming needles are better than filiform needles, fire needles are better than warming needles, fire needles are better than electroacupuncture, fire needles are better than filiform needles, Fu’s acupuncture is better than electroacupuncture, Fu’s acupuncture is better than filiform needles, and fire needle plus filiform needle is better than filiform needles alone. In terms of the visual analogue scale score, warming needles are better than electroacupuncture, warming needles are better than filiform needles, fire needles are better than electroacupunture, fire needles are better than filiform needles, Fu’s acupuncture is better than electroacupuncture, Fu's acupuncture is better than filiform needles, fire needle plus filiform needle is better than electroacupuncture. Efficiencies rank from the best to the worst: Fu’s electroacupuncture>fire needle>fire needle plus filiform needle>warming needle>electroacupuncture needle>filiform needles. The visual analogue scale scores rank as follows: Fu’s acupuncture>fire needle+filiform needle>fire needle>warming needle>filiform needle>electroacupuncture. The direct meta-analysis results are highly consistent with the network meta-analysis results, indicating that there is consistency between the direct and indirect comparison, that is, transitive. In the clinical treatment of lateral epicondylitis, Fu’s acupuncture can be preferentially selected, but each acupuncture therapy has advantages and disadvantages. In clinical practice, the appropriate treatment should be selected in accordance with the actual situation and dialectical Chinese medicine.
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Background: Lateral epicondylitis is an overuse injury of the tendon and involving the extensor muscle of forearm. Induced pain at the upper trapezius (UT) produces an increase in wrist extensor electromyographic activity (EMG) which could potentially lead to overuse injury, such as LE, at the elbow. Some studies found that there is a relation between scapular muscle muscle performance and lateral epicondylitis and loss of grip strength in lateral epicondylitis. There is a lack of literature of similar studies among computer operators. The most common wrong working posture in computer operator is excessive wrist extension it causes to the overuse injury like lateral epicondylitis. The context and purpose of the study: To find out the relationship between scapular muscle performance and grip strength in lateral epicondylitis among computer operators. Result: The correlation between scapular muscle performance and grip strength in LE among computer operators was done using Karl Person correlation coefficient. The result indicated that there is a significant relation between scapular muscle performance and grip strength in lateral epicondylitis. Conclusion: The study showed that there is an impairment of scapular muscle performance and grip strength in lateral epcondylitis among computer operators. Implication: Regular physical activity and proper ergonomics advice can improve quality of life among computer operators.
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Background: Lateral epicondylitis (LE) is a common soft tissue condition treated by many physical therapists. It has poor long-term outcomes for the non-surgical management which suggests a less than optimal rehabilitation process, so there is a need to assess proximal kinetic chain. Objectives: The objective of the study is to compare shoulder rotator muscle strength and shoulder rotation range of motion (ROM) in patients with LE with age-matched healthy individuals. Materials and Methods: An observational study was conducted on 28 subjects with LE (Group A) and 28 age-matched healthy individuals (Group B), selected by convenience sampling. The strength of shoulder rotator muscles was assessed with the use of handheld dynamometer. Shoulder rotation ROM was assessed using standard goniometer. Results: Shoulder external rotators were 9% weaker on dominant side (P = 0.02) while no differences were seen for shoulder internal rotator (IR) strength (P = 0.2). For Group B, shoulder external rotators were 11% stronger on dominant side (P = 0.04), while No dominance difference was seen for shoulder IR strength (P = 0.5). For both Group A and Group B, shoulder rotation ROM showed no significant difference between dominant and non-dominant sides. For between-group analysis, shoulder rotation ROM and shoulder rotator strength showed no statistically significant difference between the Groups A and B. Conclusion: There is muscular imbalance of shoulder rotators in LE.
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ABSTRACT Objective: To evaluate the outcomes of patients that underwent arthroscopic surgery for lateral epicondylitis (LE), after failed conservative treatment. Methods: One hundred four patients with LE treated with arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon were enrolled in this retrospective study. They were evaluated using Disabilities of the Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) and Short Form Health Survey (SF-36) scale. Mean age at surgery was 46.9 years. Duration of symptoms was 2.1 years (range: 6 m to 10 yrs.). Mean follow-up was 34.4 months (range: 6 to 68 m). Results: Mean postoperative scores were: 20.67 points on the DASH; 1.8 points on the VAS at rest, with 48 cases (46%) without pain, 40 (38%) with mild pain, 13 (13%) with moderate pain and 4 (4%) with severe pain; 4.7 points on the VAS in activity, with 21 (20%) without pain, 21 (20%) with mild pain, 35 (34%) with moderate pain and 27 (26%) with severe pain; and SF-36 was 66.8 points. Of the 23 patients who practiced sports regularly or with higher physical demand from the upper limbs, 17 (74%) were able to return to the same activity at the same level. No significant complications were observed postoperatively, except for 3 (2.8%) cases of postoperative superficial infection. Conclusion: Surgical treatment with arthroscopy for recalcitrant LE is effective and safe, presenting positive outcomes in the studied patients. Level of evidence IV, Case Series.
RESUMO Objetivo: Avaliar os resultados dos pacientes submetidos a tratamento cirúrgico artroscópico da epicondilite lateral (EL) refratária depois da falha no tratamento conservador. Métodos: Estudo retrospectivo que incluiu 104 pacientes submetidos a desbridamento artroscópico do tendão extensor radial curto do carpo (ERCC) para tratamento de EL. Os pacientes foram avaliados pelo escore de DASH, pela classificação visual analógica de dor (EVA) e pelo Short-Form 36 (SF36). A média da idade foi de 46,9 anos (variação de 30 a 69 anos). O tempo de sintomas foi de 2,1 anos (variação de 6 meses a 10 anos). O seguimento médio foi de 34,4 meses (variação de 6 - 68 meses). Resultados: A média dos escores pós-operatórios foi de: 20,67 pontos no DASH; 1,8 pontos no EVA de repouso, sendo 48 (46%) sem dor, 40 (38%) com dor leve, 13 casos (13%) com dor moderada e 4 (4%) com dor intensa; 4,7 pontos no EVA em atividade, sendo 21 (20%) sem dor, 21 (20%) com dores leves, 35 (34%) com dores moderadas e 27 (26%) com dores intensas; e SF-36 de 66,8. Dos 23 pacientes em prática constante de esporte ou com maior demanda física nos membros superiores, 17 (74%) conseguiram retornar ao mesmo nível. Não observamos complicações significativas exceto por 3 (2,8%) casos de infecção pós-operatória superficial. Conclusão: O tratamento artroscópico para EL recalcitrante do cotovelo é eficaz e seguro, apresentando resultados positivos. Nível de Evidencia IV, Série de Casos.
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Background: Tennis elbow is a syndrome of insidious onset with tenderness, pain in movement and decline in grip strength. Pulsed Electromagnetic Therapy (PEMF) and ultrasonic therapies (U.S. therapies) are proving adjuncts for enhancing fracture healing, reducing inflammation and symptom relief to varied extent in different reports. The benefit of two therapy regimens in tennis elbow is comparatively evaluated in patient of our region. Methods: 60 patients sequentially enrolled following informed consent were administered either PEMF or ultrasound therapy daily for 6 weeks. Parameters examined were pain score, pressure pain threshold (PPT) and pain free grip strength (PFGS). . Results: It was found that either of the therapies PEMF and U.S.therapy significantly improved the three tested parameters. The relative improvement in pain score between two treatment groups did not significantly differ. PEMF give significantly higher gain in PPT and very marked gain in PFGS as compared to U.S. therapy. Conclusion: PEMF therapy was found to yield significantly superior relief than ultrasound therapy in patient of lateral epicondylitis with respect to pain, pressure pain threshold (PPT) and pain free grip strength (PFGS). Improvement in pain score was similar in two groups.
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Resumen Introducción La epicondilitis o codo de tenista es una enfermedad frecuente en el codo, tiene un perfil ocupacional claro, al igual que otras tendinopatías crónicas de las extremidades superiores, y puede aparecer asociada a ellas simultáneamente. La fricción transversal profunda (o Cyriax) ha sido una de las intervenciones fisioterapéuticas sugeridas para el tratamiento de la tendinopatía. Sin embargo, las conclusiones de las investigaciones han sido inconsistentes. Por lo tanto, este estudio intentó aclarar la asociación entre el tratamiento con Cyriax y el codo de tenista a través de un metaanálisis. Material y métodos Se recuperaron las bases de datos de PubMed y EBSCO para recopilar todas las publicaciones sobre la asociación entre el tratamiento con Cyriax y la epicondilitis. Resultados La búsqueda bibliográfica consistió en 10 artículos (que incluyeron 240 casos y 227 controles) para un análisis cualitativo y seis más (que incluyeron 121 casos y 122 controles) para el cuantitativo. Conclusión Este metaanálisis no pudo apoyar una asociación significativa entre la terapia con Cyriax y la epicondilitis. Por lo tanto, se sugiere implementar esta fisioterapia sólo como un tratamiento complementario.
Abstract Introduction Epicondylitis or tennis elbow is a common disease of the elbow that has a clear occupational profile, like other upper extremity chronic tendinopathies, and can appear associated with them simultaneously. Deep transverse friction (or Cyriax) has been one of the physiotherapy interventions suggested for the management of tendinopathy. However, the conclusions of the investigations have been inconsistent. Therefore, this study aimed to clarify the association between Cyriax treatment and tennis elbow through a meta-analysis. Material and methods The PubMed and EBSCO databases were retrieved to collect all publications on the association between Cyriax treatment and epicondylitis. Results The literature search consisted of 10 articles (that included 240 cases and 227 controls) for a qualitative analysis and six more (that included 121 cases and 122 controls) for the quantitative one. Conclusion This meta-analysis could not support a significant association between Cyriax therapy and epicondylitis. Therefore, it is suggested to implement this physical therapy only as a complementary treatment.
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Objective To explore the clinical efficacy of ultrasound - guided injection of platelet-rich plasma (PRP) for the treatment of recalcitrant lateral epicondylitis. Methods From September 2014 to June 2016, a total of 15 patients with recalcitrant lateral epicondylitis received ultrasound - guided injection of autologous PRP therapy, including via left arm injection (n=2) and via right arm injection (n=13). By using twice centrifugal method, the patient' s own venous whole blood was centrifuged to obtain PRP. All patients underwent PRP injection once a week, a total of 3 treatments were performed for each patient. Results After the first injection of PRP, the patients were followed up for 12 months. One month after the treatment, visual analogue scale (VAS) score was obviously improved, at 3 months after the treatment the improvement of VAS score reached its peak and it remained at this level until 12 months after the treatment. The elbow joint function, which was evaluated with modified MAYO elbow score, was also significantly improved in one month after the treatment, and the clinical effect was sustained to 12 months after the treatment. Conclusion Ultrasound - guided precise injection of PRP can effectively improve the pain and the elbow joint function caused by recalcitrant lateral epicondylitis. (J Intervent Radiol, 2018, 27:238-241)
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Objectives In order to evaluate the clinical effect of manipulation combined with traditional Chinese medicine for the lateral epicondylitis.Methods A total of 150 patients with lateral epicondylitis were randomly divided into two groups, 75 patients in each group. The treatment group received manipulation combined with the TCM herbal bathing decoction, and the control group received the shock wave therapy and TCM herbal bathing decoction. Two groups were treated for 3 months. The SF-McGill scale, VAS, PPI, PRI were measured, and the clinical curative effect rate was assessed after treatment.Results The total effective rate of the treatment group was 92.0% (69/75), and the control group was 80.0% (60/75). There was statistical significant difference between two groups (χ2=8.339,P=0.039). The SF-McGill pain questionnaire scores, after treatment (26.3 ± 9.9vs. 29.4 ± 8.8, t=-4.183), one month after treatment (20.5 ± 7.7vs. 25.6 ± 6.9, t=-3.954), and 3 months after treatment (14.4 ± 8.0vs. 18.3 ± 6.7,t=-4.031) in the treatment group were significantly lower than those in the control group (P<0.05). The VAS scores after treatment (4.9 ± 1.4vs. 5.8 ± 1.3,t=-4.631), one month after treatment (3.0 ± 1.0vs. 4.1±1.2,t=-3.752), and three months after treatment (2.3 ± 1.0vs. 3.0 ± 1.3,t=-4.350) in the treatment group were significantly lower than those in the control group (P<0.05). The PPI score after treatment (2.4 ± 0.6vs. 3.1 ± 0.5,t=-7.528), one month after treatment (1.8 ± 0.6 vs. 2.5 ± 0.7,t=-6.630), and 3 months after treatment (1.1 ± 0.4vs. 1.9 ± 0.7,t=-3.425) in the treatment group were significantly lower than those in the control group (P<0.05). The PRI score after treatment (19.5 ± 8.0vs. 22.3 ± 5.7,t=-3.574), one month after treatment (13.7 ± 4.7vs. 17.3 ± 5.3,t=-3.985), and three months after treatment (9.3 ± 6.6vs. 12.5 ± 4.8,t=-1.270) in the treatment group were significantly lower than those in the control group (P<0.05).Conclusions The Manipulation combined with traditional Chinese medicine bathing therapy can relief the symptoms of lateral epicondylitis, and improve the clinical curative effect.
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Lateral epicondylitis with rupture of the radial collateral ligament of the elbow has not been reported in the literature. We report on a case of a recreational golfer who had not received steroid injection and had no trauma history. The patient was treated with open surgical repair. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. The authors report this case and review the literature.
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Humans , Collateral Ligaments , Elbow , Follow-Up Studies , Ligaments , Rupture , Rupture, Spontaneous , TendonsABSTRACT
Typically, Japanese Kampo doctors use formulas classified for treating blood stasis, to treat pain. However,there have been few reported cases where pain was treated with formulas classified for treating qi stagnation. Here, we report a case of right lateral epicondylitis in a 48-year-old woman who was treated with a focus on qi stagnation and with uyakujunkisan. She underwent conservative treatment at an orthopedic clinic for ten months, but her pain was not relieved. Hence, she opted for Kampo treatment. She was in a state of melancholy, felt heaviness throughout her body, and had irregular menstruation. These symptoms were mainly related to qi stagnation, and hence, we chose uyakujunkisan without white silkworm, but with aconite root. One month later, the stiffness in her shoulder improved and the pain was reduced. Magnetic resonance imaging taken 2 months later showed an improvement in the lesion. Nine months later, her menstruation became regular, and 11 months later, the pain had almost completely resolved and she could comfortably perform activities of daily living. Uyakujunkisan is introduced in the classical textbooks, and we interpret uyakujunkisan as a formula that can treat pain with qi stagnation. In Kampo treatment, effective pain treatment involves consideration of not only local blood stasis but also general qi stagnation.
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Lateral epicondylitis with rupture of the radial collateral ligament of the elbow has not been reported in the literature. We report on a case of a recreational golfer who had not received steroid injection and had no trauma history. The patient was treated with open surgical repair. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. The authors report this case and review the literature.
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Humans , Collateral Ligaments , Elbow , Follow-Up Studies , Ligaments , Rupture , Rupture, Spontaneous , TendonsABSTRACT
@#Objective To compare the effects of filiform-fire needle and warming needle on rehabilitation of lateral epicondylitis. Methods 90 patients with lateral epicondylitis were randomized into 2 groups to receive filiform-fire needle and warming needle treatment respectively based on rehabilitation training. Their clinical efficacy, total and item scores of Elbow Functional Scale were compared. Results The clinical efficacy was better in the filiform-fire needle group than in the warming needle group (P<0.05). There was no significant difference in the total scores of Elbow Functional Scale between 2 groups. However, the scores of symptoms and signs improved more in the infiliformfire needle group 2 and 4 weeks after the treatment (P<0.05), while the scores of daily living improved more in the warming needle group 2 weeks after treatment (P<0.05). Conclusion Both filiform-fire needle and warming needle could recover the elbow function of lateral epicondylitis patients based on the rehabilitation training. The former is advanced in relieving symptoms and signs, while the latter is in improving daily living in short time.
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OBJECTIVE: To evaluate the effectiveness of initial extracorporeal shock wave therapy (ESWT) for patients newly diagnosed with lateral or medial epicondylitis, compared to local steroid injection. METHOD: An analysis was conducted of twenty-two patients who were newly confirmed as lateral or medial epicondylitis through medical history and physical examination. The ESWT group (n=12) was treated once a week for 3 weeks using low energy (0.06-0.12 mJ/mm2, 2,000 shocks), while the local steroid injection group (n=10) was treated once with triamcinolone 10 mg mixed with 1% lidocaine solution. Nirschl score and 100 point score were assessed before and after the treatments of 1st, 2nd, 4th and 8th week. And Roles and Maudsley score was assessed one and eight weeks after the treatments. RESULTS: Both groups showed significant improvement in Nirschl score and 100 point score during the entire period. The local steroid injection group improved more in Nirschl score at the first week and in 100 point score at the first 2 weeks, compared to those of the ESWT group. But the proportion of excellent and good grades of Roles and Maudsley score in the ESWT group increased more than that of local steroid injection group by the final 8th week. CONCLUSION: The ESWT group improved as much as the local steroid injection group as treatment for medial and lateral epicondylitis. Therefore, ESWT can be a useful treatment option in patients for whom local steroid injection is difficult.
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Humans , Lidocaine , Physical Examination , Shock , TriamcinoloneABSTRACT
PURPOSE: The purpose of this study is to evaluate the clinical effectiveness of a rehabilitation program for the patients with lateral epicondylitis. MATERIALS AND METHODS: Twenty-three patients with lateral epicondylitis were included from April 2009 to October 2009 and all the patients were treated with a rehabilitation program for 6 weeks. The evaluation at baseline and at 12 weeks after rehabilitation included the subjective assessment of symptoms and the objective assessment with measuring the grip strength and muscle power of the wrist extensors and flexors and the forearm supinators and pronators. After 6 months, subjective satisfaction was evaluated via telephone calls. The data was analyzed using the Wilcoxon signed rank test (SPSS ver. 16.0). RESULTS: At 12 weeks, the subjective satisfaction was improved in on the three questionnaires. The grip strength increased from 25.1 kg to 37.8 kg (p<0.05). On the Biodex analysis, there was significant difference at the wrist extensors. At 6 months, 21 cases had excellent or good results according to the score and 2 cases complained of remaining pain. CONCLUSION: Our rehabilitation program is thought to be good treatment for the patients with lateral epicondylitis, and it is a practical and precautionary step for the cases of lateral epicondylitis if the patients themselves are educated to volutarily participate in the program.
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Humans , Elbow , Forearm , Hand Strength , Muscles , Surveys and Questionnaires , Telephone , WristABSTRACT
PURPOSE: To compare clinical outcomes of extracorporeal shockwave therapy and platelet-rich plasma injection for the treatment of lateral epicondylitis of the elbow. MATERIALS AND METHODS: Consecutive patients with a lateral epicondylitis who had refractory elbow pain more than 6 months and no response to treatment more than 3 months were recruited for this study. Diagnosis was made on the basis of physical examination and ultrasound imaging study. Prospective randomized trial was performed between two treatment groups; extracorporeal shockwave therapy versus platelet-rich plasma injection. Fifty patients for each group were allocated based on the results of power analysis. Disabilities of arm, shoulder and hand (DASH) scores obtained before treatment and at 1 year after the last treatment were compared between two groups. RESULTS: Both groups showed significant improvement of DASH scores after treatment. The patients who had platelet-rich plasma injection showed significantly greater improvement of DASH scores (from 37.0 to 11.1) than the patients who had extracorporeal shockwave therapy (from 41.9 to 29.9). CONCLUSION: Better subjective outcomes can be expected after platelet-rich plasma injection compared with extracorporeal shockwave therapy in patients with a refractory lateral epicondylitis.