Lateral epicondylitis, more commonl...

Lateral epicondylitis, more commonly known as tennis flexure has an annual incidence of 1 to 3 percent in the general population. This condition currents with pain over the lateral epicondyle of the humerus that is made worse with resisted dorsiflexion of the wrist. generally multiple treatment strategies are available for this condition. pair commonly used approaches include physical therapy and use of a forearm brace that straps across the muscle belly of the wrist extensors. Despite belonging to all use of these modalities, information as to the effectiveness of these treatments is limited. Struijs and colleagues examined the effectiveness of brace-only treatment, physical therapy, and a combination of these pair treatments in patients with tennis elbow

The trial was a randomized investigation of patients who had a diagnosis of tennis push for at least six weeks. Patients were included if they had pain above the lateral epicondyle that was exacerbated from pressure over the area and from resisted dorsiflexion of the wrist. Patients were assessed before the thought for personal characteristics, comorbidities, and baseline values of the issue measures. They were then assigned randomly to receive the forearm brace alone, physical therapy alone, or both

Those who received the forearm brace were provided with instructions for its use. Those who received physical therapy attended nine sessions across a six-week period. Modalities provided during physical therapy followed a standardized protocol. A blinded assessor evaluated the patients six weeks and united year after randomization. A questionnaire was mailed to participants at week 26 of the investigation The main assessment included a global measure of improvement, severity of patients' complaints, score of pain intensity, and scores in succession a modified Pain Free Function Questionnaire.

The thought included 180 patients. The three collections did not differ with regard to baseline characteristics. Physical therapy alone provided better be the effects when compared with the use of the brace alone at six weeks and for pain, disability, and satisfaction. The brace-only collection had better results than physical therapy in their ability to perform activities of daily living. The combination collection had superior results when compared with the brace-only clump in severity of complaints, disability, and satisfaction. However, at 26 and 51 weeks, no significant differences were noted among the three arranges with regard to the main issue measures.

The authors decide that the brace-only treatment for patients with tennis bend seems to be useful initially in confines of daily activities, even yet the physical therapy group in their contemplation did better with pain, disability, and satisfaction rises over the short term. Combination therapy provides better short-term deductions but no long-term benefits compared with brace-only treatment. They add that the best course may be to start with a brace as supportive therapy after the initial presentation and to husband physical therapy for use in patients who fail to suit to the brace.

KARL E MILLER, MD

Struijs PA, et al. Conservative treatment of lateral epicondylitis. Brace versus physical therapy or a combination of both--a randomized clinical trial. Am J Sports M March 2004;32:462-9

COPYRIGHT 2004 American Academy of Family Physicians

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