Lateral Epicondylitis
Conditions
Keywords
physiotherapy, manual therapy, acupuncture, eccentric exercise
Brief summary
Work-related upper extremity disorders are common problems in working populations in western countries. Lateral epicondylitis (LE) or tennis elbow is the most frequent type of soft tissue syndrome of the elbow, with an annual incidence of four to seven cases per 1000 patients in general practice, and as high as 15 % of workers in highly repetitive hand task industries. LE is a painful condition, leading to loss of function of the affected limb. Therefore it can have a major impact on the patient's work and personal life. If untreated, it persists for an average of six to 24 months and associated with significant sickness absence in 5 % of affected working-aged adults. The cost is therefore high, both in terms of loss of productivity and health care utilization. Many treatments have been advocated in the management of LE, possibly implying that much is unknown about its etiology and how it best should be treated. Systematic reviews have failed to draw any firm conclusions as to what treatment is most effective in managing this condition. Over the past 10 years acupuncture has gained wider acceptance for treating pain, by both clinicians and consumers of health, and there is some evidence suggesting that acupuncture treatment is effective in of acute symptoms in LE. A recent study supports that also elbow manipulation have a short-term relief of acute symptoms in LE, especially when combined with eccentric exercise. Our study will therefore explore the clinical effectiveness of physiotherapy versus acupuncture treatment of LE, compared with watchful waiting.
Detailed description
The study design is three armed and randomized, single blinded. The study aims, in a pilot stydy, to test if physiotherapy or acupuncture treatment of lateral epicondylitis, compared with watchful waiting, is useful means in pain relief for patients with lateral epicondylitis.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Lateral epicondylitis LE (duration \> 2 weeks) * Unilateral localization * Individuals with average pain of NRS 4 or higher during the last week prior to screening * Aged between 18 and 67 years * Written informed consent
Exclusion criteria
* Corticosteroid injections during the last 4 weeks * Diseases of the central or peripheral nervous system * Inflammatory rheumatic diseases * Radio-ulna or radio humeral osteoarthritis * Unwilling to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Elbow pain on Numeric Rating Scale (0-10) | 12 weeks and 1 year | present, worst and lesser pain during the last week, an average score will be calculated |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of life by EQ-5D | 12 weeks and 1 year | Quality of life |
| Sick listing | 12 weeks and 1 year | Number of days patients are sich listed during the 12 week study period |
| The disabilities of the arm shoulder and hand (quick-DASH) | 12 weeks and 1 year | Functional capacity of elbow and arm |
| Use of analgesics | 12 weeks and 1 year | — |
| Number of treatment sessions | 4 weeks | — |
| Patients satisfaction; global perceived effect and satistfaction with treatment | 12 weeks and 1 year | — |
Countries
Norway