Journal articles: 'Lateral epicondylitis (tennis elbow)'

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Ialenti, Marc, and Leonard Buller. "Lateral Epicondylitis (Tennis Elbow)." Reviews at LibraryOfMedicine.com 1, no. 3 (December 22, 2014): 1. http://dx.doi.org/10.16963/rlom.v1i3.5.

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Barrington, John, and William D. Hage. "Lateral epicondylitis (tennis elbow)." Current Opinion in Orthopaedics 14, no. 4 (August 2003): 291–95. http://dx.doi.org/10.1097/00001433-200308000-00013.

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Gellman, Harris. "Tennis Elbow (Lateral Epicondylitis)." Orthopedic Clinics of North America 23, no. 1 (January 1992): 75–82. http://dx.doi.org/10.1016/s0030-5898(20)31716-8.

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Saeed, Usama Bin, Talha Bind Saeed, and Sundus Tariq. "TENNIS ELBOW." Professional Medical Journal 25, no. 02 (February 10, 2018): 196–200. http://dx.doi.org/10.29309/tpmj/2018.25.02.442.

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Introduction: Lateral epicondylitis, also called as Tennis Elbow is the primarycause of musculo-skeletal ache including extensor origin of forearm. Repetitive movements areconsidered to be the root cause of this disorder. This disorder involves overexertion of fingers andwrist extensors that causes significant disability ultimately affecting the quality of life. The basisfor diagnosing lateral epicondylitis is very clear clinically. The strategy of injecting steroid locallyhas proven to dispense predictable and consistent transient relief of pain. Recent treatmentinvolve Platelet Rich Plasma (PRP) administration locally. Study Design: Prospective study.Period: 01-07-2014 to 30-06-2016. Setting: Department of Orthopedic Surgery Allied /DHQHospital Faisalabad. Subject and Methods: Total of 38 patients aging 25-60 years belongingto either gender with Lateral Epicondylitis who met inclusion criteria were enrolled in this studyand divided in two (2) groups A and B. The group which was treated with steroid injection waslabeled as A and group B comprised of patients which were treated with prepared PRP injection.Outcome was analyzed on the basis of Visual Analogue Scale of pain and functional outcomeusing qDash scores at baseline, 6 weeks and 12 weeks. Results: In Group A, baseline VASwas 7.3 + 2.1 and q DASH was 83+1.2. At 6 weeks and 12 weeks VAS was 5.3+ 3.1 and 6.1+1.2 respectively. qDash scores were 78 + 4.2 and 63 + 1.6 at 6 and 12 weeks respectively.In Group B VAS was 7.2+ 2.2, 5.3 +1.3, 3.2+ 1.2 at baseline, 6 weeks and 12 weeks. WhileqDash Scores were 81+3.2, 74+3.7, 58+1.2 at baseline, 6 weeks and 12 weeks respectively.Conclusion: Steroid and PRP are effective equally for treating lateral epicondylitis. Accordingto this study, PRP is ranked superior to steroid for its long term effectiveness in controlling painand improve functional outcome.

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Islam, Mohammad Tariqul, M. A. Shakoor, Afsana Mahjabin, and Md Ali Emran. "Effects of intralesional platelet-rich plasma in the patients with lateral epicondylitis of elbow." Bangabandhu Sheikh Mujib Medical University Journal 12, no. 3 (October 3, 2019): 138–41. http://dx.doi.org/10.3329/bsmmuj.v12i3.43326.

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Lateral epicondylitis (tennis elbow) is a major cause of musculoskeletal pain involving common extensor origin of the forearm. This study was done to determine the effects of platelet-rich plasma on 15 patients with lateral epicondylitis. Selected patients were given intralesional platelet-rich plasma injection, activity of daily living instructions and paracetamol. Patients were assessed every 14 days interval by visual analogue scale, and the patient rated tennis elbow evaluation. Treatment response according to visual analogue scale and patient rated tennis elbow evaluation tool, the difference of improvement was found in respect to time, from pretreatment W1 (just before 1st Intervention) score to W11 score in every alternate week (p<0.005). This indicates that intralesional platelet-rich plasma is effective in the patients with lateral epicondylitis of elbow.

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Kroslak, Martin, and George A. C. Murrell. "Surgical Treatment of Lateral Epicondylitis." Orthopaedic Journal of Sports Medicine 5, no. 3_suppl3 (March 1, 2017): 2325967117S0012. http://dx.doi.org/10.1177/2325967117s00120.

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Objectives: A number of surgical techniques for managing tennis elbow have been described, one of the commonest (Nirschl & Pettrone. J Bone Joint Surg Am, 61(6A): 832-839) involves excising the affected portion of extensor carpi radialis brevis (ECRB) origin. The results of this technique, as well as most other described surgical techniques for this condition, have been reported as excellent, yet none have been compared with placebo surgery. Methods: This study was a prospective, randomised, double blinded, placebo controlled clinical trial investigating the surgical excision of the macroscopically degenerated portion of ECRB (Nirschl technique; n=13) compared with a sham operation (skin incision and exposure of ECRB alone; n=13) to manage tennis elbow, in patients with tennis elbow for more than 6 months who failed at least two non-surgical modalities. The primary outcome measure was defined as patient rated frequency of elbow pain with activity at 6 months post-surgery. Secondary outcome measures included patient rated frequency and severity of pain, functional outcomes, range of motion, epicondyle tenderness and strength at 6 months and >12 months post-surgery. Results: The two groups were matched for age, gender, hand dominance and duration of symptoms. Both the surgery and placebo procedures improved patient rated pain frequency and severity, elbow stiffness, difficulty with picking up objects, twisting motions and overall elbow rating over 6 months and at >12 months (p<0.01). Both procedures also improved epicondyle tenderness, pronation-supination range, grip strength and modified ORI-TETS at 6 months (p<0.05). No significant difference was observed between the groups in any parameter at any stage. No side effects or complications were reported. The study was stopped before the calculated number of patients were enrolled, as a post-hoc analysis showed over 6500 patients would need to be recruited in each group to see a significant difference between the groups at 26 weeks, when measuring patient rated frequency of elbow pain with activity. Conclusion: This study indicates that the surgical excision of the degenerative portion of ECRB offers no additional benefit over and above placebo surgery for the management of chronic tennis elbow. [Figure: see text]

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Dunn, Jonathan H., John J. Kim, Lonnie Davis, and Robert P. Nirschl. "Ten- to 14-Year Follow-up of the Nirschl Surgical Technique for Lateral Epicondylitis." American Journal of Sports Medicine 36, no. 2 (November 30, 2007): 261–66. http://dx.doi.org/10.1177/0363546507308932.

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Background Good to excellent short-term results have been reported for the surgical treatment of lateral epicondylitis using various surgical techniques. Hypothesis Surgical treatment for lateral epicondylitis using the mini-open Nirschl surgical technique will lead to durable results at long-term follow-up. Study Design Case series; Level of evidence, 4. Methods Records from 139 consecutive surgical procedures (130 patients) for lateral epicondylitis performed by 1 surgeon between 1991 and 1994 were retrospectively reviewed. Eighty-three patients (92 elbows) were available by telephone for a mean follow-up of 12.6 years (range, 10–14 years). Outcome measures included the Numeric Pain Intensity Scale, Nirschl and Verhaar tennis elbow–specific scoring systems, and American Shoulder and Elbow Surgeons elbow form. Preoperative data were collected retrospectively. Results The mean age of the study group was 46 years (range, 23–70 years) with 45 men and 38 women. Eighty-seven of the procedures were primary, and 5 were revision tennis elbow surgeries. Concomitant procedures were performed in 30 patients including ulnar nerve release in 24 patients, medial tennis elbow procedures in 23 patients, shoulder arthroscopy in 2 patients, carpal tunnel release in 1 patient, and triceps debridement and osteophyte excision in 1 patient. The mean duration of preoperative symptoms was 2.2 years (range, 2 months to 10 years). The mean Nirschl tennis elbow score improved from 23.0 to 71.0, and the mean American Shoulder and Elbow Surgeons score improved from 34.3 to 87.7 at a minimum of 10-year follow-up ( P < .05). The Numeric Pain Intensity Scale pain score improved from 8.4 preoperatively to 2.1 ( P < .05). Results were rated as excellent in 71 elbows, good in 6 elbows, fair in 9 elbows, and poor in 6 elbows by the Nirschl tennis elbow score. By the criteria of Verhaar et al, the results were excellent in 45 elbows, good in 32 elbows, fair in 8 elbows, and poor in 7 elbows. Eighty-four percent good to excellent results were achieved using both scoring systems. Ninety-two percent of the patients reported normal elbow range of motion. The overall improvement rate was 97%. Patient satisfaction averaged 8.9 of 10. Ninety-three percent of those available at a minimum of 10-year follow-up reported returning to their sports. Conclusion The mini-open Nirschl surgical technique with accurate resection of the tendinosis tissue remains highly successful in the long term.

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Glousman, Ronald E. "Surgical treatment of lateral epicondylitis (tennis elbow)." Techniques in Orthopaedics 6, no. 1 (March 1991): 33–38. http://dx.doi.org/10.1097/00013611-199103000-00008.

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Stasinopoulos, D. "Cyriax physiotherapy for tennis elbow/lateral epicondylitis." British Journal of Sports Medicine 38, no. 6 (December 1, 2004): 675–77. http://dx.doi.org/10.1136/bjsm.2004.013573.

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Titchener, A. G., A. Fakis, A. A. Tambe, C. Smith, R. B. Hubbard, and D. I. Clark. "Risk factors in lateral epicondylitis (tennis elbow): a case-control study." Journal of Hand Surgery (European Volume) 38, no. 2 (April 4, 2012): 159–64. http://dx.doi.org/10.1177/1753193412442464.

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Lateral epicondylitis is a common condition, but relatively little is known about its aetiology and associated risk factors. We have undertaken a large case-control study using The Health Improvement Network database to assess and quantify the relative contributions of some constitutional and environmental risk factors for lateral epicondylitis in the community. Our dataset included 4998 patients with lateral epicondylitis who were individually matched with a single control by age, sex, and general practice. The median age at diagnosis was 49 (interquartile range 42–56) years . Multivariate analysis showed that the risk factors associated with lateral epicondylitis were rotator cuff pathology (OR 4.95), De Quervain’s disease (OR 2.48), carpal tunnel syndrome (OR 1.50), oral corticosteroid therapy (OR 1.68), and previous smoking history (OR 1.20). Diabetes mellitus, current smoking, trigger finger, rheumatoid arthritis, alcohol intake, and obesity were not found to be associated with lateral epicondylitis.

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SHAH, FAAIZ ALI, HAZIQDAD KHAN, and KIFAYAT ULLAH. "CHRONIC TENNIS ELBOW." Professional Medical Journal 18, no. 04 (December 10, 2011): 621–25. http://dx.doi.org/10.29309/tpmj/2011.18.04.2650.

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Objectives: To evaluate the results of autologous blood injection as a treatment for chronic tennis elbow (Lateral Epicondylitis). Study Design: Descriptive case- series. Setting and Duration: Orthopaedic Surgery Unit Mardan Medical Complex Teaching hospital Bacha Khan Medical College Mardan KPK, from April 2010 to June 2011. Methodology: A total of 22 patients with tennis elbow (lateral epicondylitis) were injected with 2 mL of autologous blood under the extensor carpi radialis brevis in the Out-Patient Department (OPD). Patients rated their pain on a Visual Analogue Scale(VAS) scale of 0 to 10 with 0 representing no pain and 10 the worst pain they had ever experienced, and categorized themselves according to Nirschl score(1-7). After the procedure pain rating and Nirschl score were recorded every 3rd week for a minimum of 6 months. If pain relief was not relieved entirely 6 weeks after the autologous blood injection a repeat injection was offered to the patient. Results: Seventeen patients (77.2%) received one injection of autologous blood and had resulted in lowering their mean pre-injection pain score and Nirschl sore of 6.2 and 6 to 0.1 and 1.1 post-injection respectively. Five patients (22.7%) received two injections and their average pre-injection pain score of 6.8 and Nirschl score of 6.2 were lowered to 0.2 and 1 respectively. Conclusions: Autolgous blood injection is an effective way to treat patients of chronic tennis elbow as demonstrated by decrease in pain and fall in Nirschl score and we therefore recommend it as a first line treatment for chronic tennis elbow.

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Dhakal, Sita, Trishna Acharya, Savyata Gautam, Nijan Upadhyay, and Sujan Dhakal. "Diagnosis and Management Pattern of Lateral Epicondylitis in a Tertiary Care Center." Journal of Nepal Medical Association 53, no. 200 (December 31, 2015): 231–34. http://dx.doi.org/10.31729/jnma.2736.

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Introduction: Lateral Epicondylitis has been found to be the second most frequently diagnosed musculoskeletal disorder. A wide range of symptomatic treatments are available such as use of anti-inflammatory analgesic drugs, steroids, physiotherapy. This study aims to know about the diagnosis, prescription pattern and current practice on management of tennis elbow in Nepal. Methods: This is a hospital based observational study carried out at Bir Hospital, Kathmandu, Nepal. Patients diagnosed with tennis elbow were purposively selected through prospective sampling technique from Orthopedic Department. Questionnaire and patient medication files were used as tools for data collection. Results: A total of 97 patients were found to be suffering from tennis elbow affecting mostly 41-50 years of age group and seen mostly in female (62%). Further, it was found that housewives (31%) were mostly affected. Diagnosis of tennis elbow was done commonly by clinical evaluation (61%) and X-ray (39%). Both Pharmacological and Non-Pharmacological approaches were in practice. Pharmacological treatment include NSAIDS (59% Aceclofenac, 19% Naproxen, 18% Indomethacin, 16% Diclofenac, 6% Piroxicam) and Steroids (23% methylprednisolone acetate and 21% oral prednisolone). Non-Pharmacological treatment was done by lifestyle modification (100%), 78% application of heat, 63% use of tennis elbow band, 29% exercise and 28% physiotherapy. Surgical intervention (3%) was also done when the conservative management failed. Conclusions: There is professional risk of tennis elbow for housewives, farmers and shopkeepers in context of Nepal. Only one treatment approach is not effective in management of tennis elbow for long term effect. Keywords: lateral epicondylitis; NSAIDs; physiotherapy; steroid; tennis elbow.

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Verma, Shilp, Anwar A, Alok Chandra Agarwal, Ranjeet Choudhary, and Ankit Kumar Garg. "A better functional outcome with platelet rich plasma compared with local steroid injection in tennis elbow." IP International Journal of Orthopaedic Rheumatology 7, no. 1 (August 15, 2021): 24–28. http://dx.doi.org/10.18231/j.ijor.2021.006.

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Lateral epicondylitis commonly referred to as 'tennis elbow,' is mainly observed in the 3rd and 4th decade of life in around 2% -3% of the population. Treatment modalities for lateral epicondylitis include analgesics, immobilization, tennis elbow brace, local steroid infiltration, and ultrasound therapy. Recent studies have explored the effectiveness of platelet-rich plasma (PRP) injections in lateral epicondylitis. We used the block randomization technique. Two groups were prepared with 30 patients in each group. One group of patients received PRP and the other received local steroid injection. Patients were evaluated at the time of procedure and immediately after the procedure, at six weeks, three months, and six months, using the visual analog score and Liverpool's elbow score. At the end of 6 months, follow-up patients in the PRP injection group show good clinical and functional compare to the steroid group of patients. PRP and local corticosteroid injection provide symptomatic relief in the treatment of lateral epicondylitis. PRP infiltration gives better results in pain relief and functional activities with statically significant values when compared with corticosteroid injections.

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Ali, Munawar, and Thomas A. Lehman. "Lateral Elbow Tendinopathy: A Better Term Than Lateral Epicondylitis or Tennis Elbow." Journal of Hand Surgery 34, no. 8 (October 2009): 1575. http://dx.doi.org/10.1016/j.jhsa.2009.06.024.

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Mińko, Alicja, Zuzanna Hilicka, and Iwona Rotter. "THE EFFECTIVENESS OF SELECTED PHYSIOTHERAPEUTIC METHODS IN THE TREATMENT OF PAIN IN THE COURSE OF LATERAL EPICONDYLITIS OF THE HUMERUS." Issues of Rehabilitation, Orthopaedics, Neurophysiology and Sport Promotion – IRONS 35, no. 35 (June 2021): 41–50. http://dx.doi.org/10.19271/irons-000136-2021-35.

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Introduction Lateral epicondylitis, otherwise known as the tennis elbow syndrome, occurs in 1–3% of the general population, of which tennis players account for only 10%. It is one of the most common causes of upper limb pain. Currently, due to the lack of uniform and consistent therapeutic methods, various treatment techniques are used. These include techniques such as shock wave therapy, ultrasound and cryotherapy. Aim The aim of the study is to assess the effectiveness of three physiotherapeutic methods – shock wave therapy, ultrasound and cryotherapy – in reducing pain in the course of treating tennis elbow syndrome. The secondary goal is to assess the grip strength of the hand. Material and methods As a result of the review of search engines and databases, such as Polish Medical Bibliography, Google Scholar, PubMed and ScienceDirect, 10 research works from 2010–2019 were used, assessing the effectiveness of shock wave therapy, ultrasound and cryotherapy to treat lateral epicondylitis of the humerus. Results 310 people diagnosed with tennis elbow syndrome participated in the analysis. According to the results, most of the patients were female. The average age of the respondents was 45.2 years. Conclusions The research analysis proves that shock wave therapy, cryotherapy and ultrasound are effective physiotherapeutic methods in the treatment of lateral epicondylitis of the humerus. The shockwave is superior to other forms of treatment due to its shorter sessions and application time. Keywords: tennis elbow, rehabilitation, cryotherapy

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Ma, Kun-Long, and Hai-Qiang Wang. "Management of Lateral Epicondylitis: A Narrative Literature Review." Pain Research and Management 2020 (May 5, 2020): 1–9. http://dx.doi.org/10.1155/2020/6965381.

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Lateral epicondylitis, also termed as “tennis elbow,” is the most common cause of elbow pain and dysfunction, mainly resulting from repetitive gripping or wrist extension during various activities. The exact pathogenesis remains largely elusive with putative tendinosis, a symptomatic degenerative process of the local tendon. It is usually diagnosed by clinical examinations. Sometimes, additional imaging is required for a specific differential diagnosis. Although most cases can be self-healing, the optimal treatment strategy for chronic lateral epicondylitis remains controversial. This article presents a landscape of emerging evidence on lateral epicondylitis and focuses on the pathogenesis, diagnosis, and management, shedding light on the understandings and treatment for healthcare professionals.

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Clements, Linda G., and Susanna Chow. "Effectiveness of a Custom-Made below Elbow Lateral Counterforce Splint in the Treatment of Lateral Epicondylitis (Tennis Elbow)." Canadian Journal of Occupational Therapy 60, no. 3 (August 1993): 137–44. http://dx.doi.org/10.1177/000841749306000305.

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The purpose of the study was to determine the effectiveness of a custom-made below elbow lateral counterforce splint along with standard physiotherapy compared with physiotherapy alone, for the treatment of lateral epicondylitis. It was hypothesized that the recovery from lateral epicondylitis is greater following four weeks of standard physiotherapy and the use of the splint, than following four weeks of standard physiotherapy alone. The experimental group (with the splint and physiotherapy) demonstrated a significant improvement in pain (p = 0.05) and maximum grip strength (p = 0.025) of the affected arm compared to the control group. The experimental group showed a greater improvement in function approaching but not reaching significance. The results indicate that this custom-made splint is of value in facilitating the recovery from lateral epicondylitis.

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Acosta-Olivo, Carlos Alberto, Juan Manuel Millán-Alanís, Luis Ernesto Simental-Mendía, Neri Álvarez-Villalobos, Félix Vilchez-Cavazos, Víctor Manuel Peña-Martínez, and Mario Simental-Mendía. "Effect of Normal Saline Injections on Lateral Epicondylitis Symptoms: A Systematic Review and Meta-analysis of Randomized Clinical Trials." American Journal of Sports Medicine 48, no. 12 (February 11, 2020): 3094–102. http://dx.doi.org/10.1177/0363546519899644.

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Background: Lateral epicondylitis, or tennis elbow, is a painful degenerative disorder that commonly occurs in adults between 40 and 60 years of age. Normal saline (NS) injections have been used as placebo through a large number of randomized controlled trials (RCTs) focused on the treatment of lateral epicondylitis. Purpose: This meta-analysis of RCTs aimed to assess the therapeutic effect of NS injections on lateral epicondylitis symptoms and compare results with established minimal clinically important difference criteria. Study Design: Systematic review and meta-analysis. Methods: MEDLINE, Embase, Web of Science, and Scopus databases were searched for clinical trials reporting pain and joint function with the visual analog scale, Patient-Rated Tennis Elbow Evaluation, and Disabilities of the Arm, Shoulder and Hand in patients with lateral epicondylitis. The meta-analysis was conducted with a random effects model and generic inverse variance method. Heterogeneity was tested with the I2 statistic index. Results: A total of 15 RCTs included in this meta-analysis revealed a significant improvement in pain (mean difference, 3.61 cm [95% CI, 2.29-4.92 cm]; P < .00001; I2 = 88%; visual analog scale) and function (mean difference, 25.65 [95% CI, 13.30-37.99]; P < .0001; I2 = 82%; Patient-Rated Tennis Elbow Evaluation / Disabilities of the Arm, Shoulder and Hand) after NS injection (≥6 months). Conclusion: NS injections yielded a statistically significant and clinically meaningful improvement in pain and functional outcomes in patients with lateral epicondylitis. New research should focus on better methods to diminish the potential confounders that could lead to this effect because NS injections could mask the real effect of an active therapeutic intervention in RCT. Registration: CRD42019127547 (PROSPERO).

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Kim, Gyeong Min, Seung Jin Yoo, Sungwook Choi, and Yong-Geun Park. "Current Trends for Treating Lateral Epicondylitis." Clinics in Shoulder and Elbow 22, no. 4 (December 1, 2019): 227–34. http://dx.doi.org/10.5397/cise.2019.22.4.227.

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Lateral epicondylitis, also known as ‘tennis elbow’, is a degenerative rather than inflammatory tendinopathy, causing chronic recalcitrant pain in elbow joints. Although most patients with lateral epicondylitis resolve spontaneously or with standard conservative management, few refractory lateral epicondylitis are candidates for alternative non-operative and operative modalities. Other than standard conservative treatments including rest, analgesics, non-steroidal anti-inflammatory medications, orthosis and physical therapies, nonoperative treatments encompass interventional therapies include different types of injections, such as corticosteroid, lidocaine, autologous blood, platelet-rich plasma, and botulinum toxin, which are available for both short-term and long-term outcomes in pain resolution and functional improvement. In addition, newly emerging biologic enhancement products such as bone marrow aspirate concentrate and autologous tenocyte injectates are also under clinical use and investigations. Despite all non-operative therapeutic trials, persistent debilitating pain in patients with lateral epicondylitis for more than 6 months are candidates for surgical treatment, which include open, percutaneous, and arthroscopic approaches. This review addresses the current updates on emerging non-operative injection therapies as well as arthroscopic intervention in lateral epicondylitis.

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Zhu, Jihe. "Fire Needle Acupuncture Treatment for Lateral Epicondylitis (Tennis Elbow)." American Journal of Clinical and Experimental Medicine 5, no. 3 (2017): 60. http://dx.doi.org/10.11648/j.ajcem.20170503.11.

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Zeisig, Eva. "Natural course in tennis elbow—lateral epicondylitis after all?" Knee Surgery, Sports Traumatology, Arthroscopy 20, no. 12 (March 21, 2012): 2549–52. http://dx.doi.org/10.1007/s00167-012-1939-0.

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Massy-Westropp, Nicola, Stuart Simmonds, Suzanne Caragianis, and Andrew Potter. "Autologous Blood Injection and Wrist Immobilisation for Chronic Lateral Epicondylitis." Advances in Orthopedics 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/387829.

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Purpose. This study explored the effect of autologous blood injection (with ultrasound guidance) to the elbows of patients who had radiologically assessed degeneration of the origin of extensor carpi radialis brevis and failed cortisone injection/s to the lateral epicondylitis.Methods. This prospective longitudinal series involved preinjection assessment of pain, grip strength, and function, using the patient-rated tennis elbow evaluation. Patients were injected with blood from the contralateral limb and then wore a customised wrist support for five days, after which they commenced a stretching, strengthening, and massage programme with an occupational therapist. These patients were assessed after six months and then finally between 18 months and five years after injection, using the patient-rated tennis elbow evaluation.Results. Thirty-eight of 40 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not.Conclusions. Autologous blood injection improved pain and function in a worker’s compensation cohort of patients with chronic lateral epicondylitis, who had not had relief with cortisone injection.

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Duncan, James, Robert Duncan, Saksham Bansal, Dominic Davenport, and Andrew Hacker. "Lateral epicondylitis: the condition and current management strategies." British Journal of Hospital Medicine 80, no. 11 (November 2, 2019): 647–51. http://dx.doi.org/10.12968/hmed.2019.80.11.647.

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Lateral epicondylitis or tennis elbow is a common condition estimated to affect between 1 and 3% of adults. As a result of its high prevalence, both primary and secondary care physicians are frequently presented with this problem, so knowledge of its presentation and up-to-date management strategies is essential. This review collates the most recent evidence on lateral epicondylitis to help the clinician perform assessments and make treatment decisions, based on the best current clinical practice.

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Senthil P., Kumar, and Kumar Anup. "Exercise Therapy for Tennis Elbow/Lateral Epicondylitis/ Lateral Epicondylalgia/Lateral Elbow Pain: A Descriptive Overview." Journal of Orthopaedic Education 2, no. 1 (2016): 17–19. http://dx.doi.org/10.21088/joe.2454.7956.2116.4.

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Chabungbam, Margaret, Akoijam Joy Singh, Longjam Nilachandra Singh, Yumnam Ningthemba, Sreejith C., Janet Moirangthem, Chandrakant Pilania, and Tasso Opo. "Comparison between prolozone therapy and extracorporeal shockwave therapy in management of pain and function in resistant cases of lateral epicondylitis: a randomised controlled trial." International Journal of Advances in Medicine 7, no. 8 (July 21, 2020): 1216. http://dx.doi.org/10.18203/2349-3933.ijam20203121.

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Background: Lateral epicondylitis also known as the tennis elbow is a painful condition of the elbow caused by overuse. The disease imparts significant disability to those affected in terms of the quantity and quality of work done.Methods: A randomised controlled trial was conducted in the Department of Physical Medicine and Rehabilitation, RIMS, Imphal for a period of 1 year from February 2017 to January 2018. Eighty-four patients with resistant lateral epicondylitis recruited were divided into 2 groups- group A received Prolozone injection while group B underwent Extracorporeal Shockwave Therapy (ESWT).Results: Assessments of VAS (Visual Analog Scale) and PRTEE (Patient Rated Tennis Elbow Evaluation) were done at 8 weeks and 24 weeks. The mean VAS score in Prolozone group improved from 7.22±0.89 to 4.04±1.01 at 8 weeks to 1.67±0.70 at end of 24 weeks. In ESWT group, mean VAS score improved to 3.91±0.72 at 8 weeks and reduced to 2.3±0.68 at end of 24 weeks. PRTEE improved significantly in both the groups, from 85.33±3.29 to 24.87±2.10 in Prolozone group, and from 85.17±2.83 to 41.89±3.17 in ESWT group.Conclusions: The improvement in pain and disability is better in prolozone group than ESWT (p<0.05) in chronic lateral epicondylitis.

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Puri, Jetindar, and Dr Nabiha Ahmed. "EFFECTS OF DEEP FRICTION MASSAGE ON TENDINITIS (LATERAL EPICONDYLITIS) IN COMPARISON TO ULTRASOUND THERAPY." Pakistan Journal of Rehabilitation 3, no. 2 (July 5, 2014): 36–40. http://dx.doi.org/10.36283/pjr.zu.3.2/008.

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OBJECTIVE To compare the effects of deep friction massage and ultrasound therapy in subjects with tennis elbow in terms of pain, grip strength and functional activities. STUDY DESIGN Randomized Control Trial. STUDY SETTINGS AND PARTICIPANTS Study was conducted in Physiotherapy OPD of a tertiary care hospital. A sample of 50 patients were inducted in the study. Sample size calculated through open Epi calculator. OUTCOME MEASURES Patients with the diagnosed lateral epicondylitis (Tennis elbow) presenting to out Patient department of two tertiary care hospitals has been enrolled for study after written informed consent. Subjects were randomly allocated into two groups i.e. group A and group B. Group A = DFM + exercise, Group B = U/S + exercise. RESULTS Total 50 patients were randomized and divided into two groups. Group A: the mean pain score on VAS before treatment was 5.88±1.130 and after treatment 1.80±1.041 p-value=0.006. Group B: the mean pain score on VAS before treatment was 6.56±1.446 and after treatment was 2.72±1.208 p-value=0.006. Group A: the mean grip strength score was 13.92±2.691 and in after treatment was 19.60±5.454 p-value=0.342. Group B: the mean grip strength was 15.12±2.505 and after treatment was 20.92±4.183p-value=0.342. CONCLUSION The present study showed no statistical difference in using deep frictional massage therapy in relieving pain, improving grip strength and functional performance in subject with tennis elbow. KEY WORDS Tennis Elbow, Lateral Epicondylitis, Deep Friction Massage, Hand Held Dynamometer, Ultrasound Therapy, Grip Strength.

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Salikhov, M. R., I. A. Kuznetsov, G. I. Zhabin, D. A. Shulepov, and O. V. Zlobin. "ARTHROSCOPIC TREATMENT OF PATIENTS WITH LATERAL HUMERAL EPICONDYLITIS (TENNIS ELBOW)." Traumatology and Orthopedics of Russia 23, no. 4 (January 1, 2017): 58–69. http://dx.doi.org/10.21823/2311-2905-2017-23-4-58-69.

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Abbas, Sammar, Rabbiya Riaz, Aqeel Khan, Anam Javed, and Shahid Raza. "EFFECTS OF MULLIGAN AND CYRIAX APPROACH IN PATIENTS WITH SUBACUTE LATERAL EPICONDYLITIS." Rehabilitation Journal 3, no. 2 (December 31, 2019): 107–15. http://dx.doi.org/10.52567/trj.v3i02.15.

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Objective: To determine and compare the effects of Deep Transverse Friction (DTF) Massage and Mill’s manipulation (Cyriax) with Mobilization with movement (MWM) and Taping (Mulligan) in lateral epicondylitis patients. Material & Methods: A Randomized Control Trial (NCT03848117) was conducted in Physiotherapy Department of DHQ Hospital Bahawalnagar after the approval from the competent authority. Non-probability convenient sampling technique was used to collect sample. The n=30 sample size was randomly allocated in two groups as Group A i.e. the Cyriax group (DTF Massage & Mill’s Manipulation) and Group B i.e. the Mulligan group (Taping & MWM), with 15 participants in each group having sub acute lateral epicondylitis. Data was collected in terms of age, gender, BMI and occupation. Patient related tennis elbow evaluation (PRTEE) questionnaire was used to determine the level of pain, functional disability and hand grip strength. Mann Whitney U statistics test was used for between the group analysis and Friedman with Wilcoxon signed ranks test was used for within the group analysis. The significance level was set at p<0.05. Results: The mean±SD age of subjects in Cyriax group was 33.60±6.864 years and in Mulligan group was 36.93±7.741 years. MWM with taping and Mill’s manipulation with DTF massage both showed significant improvement (p<0.001) in pain, function ability and handgrip strength throughout the treatment duration. When comparing the both group regarding pain, Cyriax approach showed significant improvement after 2nd week while mulligan’s approach showed more improvement than Cyriax approach (p<0.001) in functional ability from 2ndto 3rd week. Hand grip strength in both groups did not show any significant difference (p≥0.05). Conclusion: Mobilization with movement& taping (Mulligan) and mill’s manipulation with DTF massage (Cyriax), both are effective in improving pain, functional ability and handgrip strength in lateral epicondylitis. Cyriax approach is more effective in relieving pain in lateral epicondylitis as compare to Mulligan’s approach. On the other hand, functional ability, more improve with Mulligan’s approach. But both treatments are equally effective in improving hand grip strength in lateral epicondylitis. Keywords: Tennis elbow, mobilization with movement, hand grip strength, patient rated tennis elbow evaluation (PRTEE), Deep Transverse friction massage.

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Jan, Wazir Fahad, Alamgir Jahan, Mohd Yahya Dar, and Umer Mushtaq Khan. "A study on management of tennis elbow by local platelet rich plasma injection." International Journal of Research in Orthopaedics 5, no. 4 (June 27, 2019): 703. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20192688.

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Background: Lateral epicondylitis (tennis elbow), a familiar term used to describe myriad symptoms around the lateral aspect of the elbow can occur during activities that require repetitive supination and pronation of the forearm with the elbow in near full extension. This condition can cause severe discomfort to the patient resulting in debilitation and impairment of routine activities. The purpose of this study was to evaluate the effectiveness of local autologous platelet rich plasma injection in the treatment of tennis elbow.Methods: This was a prospective observational study conducted on 50 patients of either sex with an average age of 45.92 years, presenting to the Orthopaedic OPD of SHKM Government Medical College Hospital, Nalhar, NUH, Haryana between November 2016 and February 2018, with a diagnosis of lateral epicondylitis. All the patients were treated with local platelet rich plasma injection and the results were analysed through the assessment of visual analog score (VAS) and disability of arm shoulder and hand (DASH) score. The patients were followed up for a period of 6 months after the local injection of platelet rich plasma.Results: Majority of the patients had significant relief with this method. The VAS and DASH score improved from the pre-treatment values of 8.7 and 74.6 to 2.6 and 29.8 respectively, which was found to be statistically significant (p<0.001).Conclusions: Thus results of our study demonstrate that the local injection of platelet rich plasma is a safe and effective method of treatment of lateral epicondylitis.

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Kroslak, Martin, and George A. C. Murrell. "Surgical Treatment of Lateral Epicondylitis: A Prospective, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial." American Journal of Sports Medicine 46, no. 5 (March 2, 2018): 1106–13. http://dx.doi.org/10.1177/0363546517753385.

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Background: A number of surgical techniques for managing tennis elbow have been described. One of the most frequently performed involves excising the affected portion of the extensor carpi radialis brevis (ECRB). The results of this technique, as well as most other described surgical techniques for this condition, have been reported as excellent, yet none have been compared with placebo surgery. Hypothesis: The surgical excision of the degenerative portion of the ECRB offers no additional benefit over and above placebo surgery for the management of chronic tennis elbow. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: This study investigated surgical excision of the macroscopically degenerated portion of the ECRB (surgery; n = 13) as compared with skin incision and exposure of the ECRB alone (sham; n = 13) to treat patients who had tennis elbow for >6 months and had failed at least 2 nonsurgical modalities. The primary outcome measure was defined as patient-rated frequency of elbow pain with activity at 6 months after surgery. Secondary outcome measures included patient-rated pain and functional outcomes, range of motion, epicondyle tenderness, and strength at 6 months and 2.5 years. All outcome measures up to and including the 6-month follow-up were measured in person; the longer-term questionnaire was conducted in person or over the phone. Results: The 2 groups, surgery and sham, were similar for age, sex, hand dominance, and duration of symptoms. Both procedures improved patient-rated pain frequency and severity, elbow stiffness, difficulty with picking up objects, difficulty with twisting motions, and overall elbow rating >6 months and at 2.5 years ( P < .01). Both procedures also improved epicondyle tenderness, pronation-supination range, grip strength, and modified Orthopaedic Research Institute–Tennis Elbow Testing System at 6 months ( P < .05). No significant difference was observed between the groups in any parameter at any stage. No side effects or complications were reported. The study was stopped before the calculated number of patients were enrolled (40 per group); yet, a post hoc futility analysis was conducted that showed, based on the magnitude of the differences between the groups, >6500 patients would need to be recruited per group to see a significant difference between the groups at 26 weeks in the primary outcome (patient-rated frequency of elbow pain with activity). Conclusion: With the number of available participants, this study failed to show additional benefit of the surgical excision of the degenerative portion of the ECRB over placebo surgery for the management of chronic tennis elbow.

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Sohel, DM, BK Dam, D. Roy, MAK Shamsuddin, and SK Pramanik. "Autologus Blood Injection for Lateral Epicondylitis in Tertiary Level Hospital." TAJ: Journal of Teachers Association 26 (November 28, 2018): 79–81. http://dx.doi.org/10.3329/taj.v26i0.37594.

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Tennis elbow is a common and well defined clinical entity. It is an extra articular affection characterised by pain and acute tenderness at the origin of the mainly extensorcarpi radialis brevis, but can involve the tendons of the extensorcarpi radialis longus and the extensor digitorum communis. It is also called lateral epicondylitis. Various types of treatment option for this disease that is conservative and operative. An injection of autologus blood might provide the necessary cellular and humoral mediators to induce a healing cascade. The purpose of the study was to evaluate result of epicondylitis treated with autologus blood injection.Total 19 patients with tennis elbow treated in this study.Among the patients 9 were male and 10 were female.Age of the patients were 25yrs – 60yrs, average 41.63yrs. All patients had failed previous non-surgical treatment. Duration of the pain 1 month to 6 months. All the patients got autologus blood injected every 21 days interval (one or three times). Before autologus blood injection average pain score was 6.2 and average Nirschi score was 5.8. After autologus blood injection pain score and Nirschi score decreases 2.2 and 2 respectively. Average follow-up period was 7 months.TAJ 2013; 26: 79-81

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Mohandhas, Badri R., Navnit Makaram, Tim S. Drew, Weijie Wang, Graham P. Arnold, and Rami J. Abboud. "Racquet string tension directly affects force experienced at the elbow: implications for the development of lateral epicondylitis in tennis players." Shoulder & Elbow 8, no. 3 (April 6, 2016): 184–91. http://dx.doi.org/10.1177/1758573216640201.

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Background Lateral epicondylitis (LE) occurs in almost half of all tennis players. Racket-string tension is considered to be an important factor influencing the development of LE. No literature yet exists that substantiates how string-tension affects force transmission to the elbow, as implicated in LE development. We establish a quantitative relationship between string-tension and elbow loading, analyzing tennis strokes using rackets with varying string-tensions. Methods Twenty recreational tennis players simulated backhand tennis strokes using three rackets strung at tensions of 200 N, 222 N and 245 N. Accelerometers recorded accelerations at the elbow, wrist and racket handle. Average peak acceleration was determined to correlate string-tension with elbow loading. Results Statistically significant differences ( p < 0.05) were observed when average peak acceleration at the elbow at 200 N string-tension (acceleration of 5.58 m/s2) was compared with that at 222 N tension (acceleration of 6.83 m/s2) and 245 N tension (acceleration of 7.45 m/s2). The 200 N racket induced the least acceleration at the elbow. Conclusions Although parameters determining force transmission to the elbow during a tennis stroke are complex, the present study was able to control these parameters, isolating the effect of string-tension. Lower string-tensions transmit less force to the elbow in backhand strokes. Reducing string-tension should be considered favourably with respect to reducing the risk of developing LE.

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FAIRBANK, S. M., and R. J. CORLETT. "The Role of the Extensor Digitorum Communis Muscle in Lateral Epicondylitis." Journal of Hand Surgery 27, no. 5 (October 2002): 405–9. http://dx.doi.org/10.1054/jhsb.2002.0761.

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A common finding in tennis elbow is pain in the region of the lateral epicondyle during resisted extension of the middle finger (Maudsley’s test). We hypothesized that the pain is due to disease in the extensor digitorum communis muscle, rather than to compression of the radial nerve or disease within extensor carpi radialis brevis. Thirteen human forearm specimens were examined. It was found that the extensor digitorum communis was separable into four parts. The part to the middle finger originated from the lateral epicondyle, but the muscle slips to the other fingers originated more distally. Pain ratings were measured in ten patients diagnosed with lateral epicondylitis during isometric finger and wrist extension tests. The results confirmed the high prevalence of a positive Maudsley’s test in lateral epicondylitis, and also that the patients with tenderness at the site of origin of the extensor digitorum communis slip to the middle finger had the greatest pain during middle finger extension. These anatomical and clinical findings clarify the anatomy of extensor digitorum communis, and suggest that this muscle forms the basis for the Maudsley’s test. The muscle may play a greater role in tennis elbow than previously appreciated.

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Stasinopoulos, D. "Effectiveness of extracorporeal shock wave therapy for tennis elbow (lateral epicondylitis)." British Journal of Sports Medicine 39, no. 3 (March 1, 2005): 132–36. http://dx.doi.org/10.1136/bjsm.2004.015545.

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Arnett, Justin J., Steven Mandel, Steve M. Aydin, and Christopher R. Brigham. "A Review of the Evaluation, Treatment, and Rating of Lateral Epicondylitis." Guides Newsletter 21, no. 1 (January 1, 2016): 10–13. http://dx.doi.org/10.1001/amaguidesnewsletters.2016.janfeb02.

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Abstract Lateral epicondylitis, often called “tennis elbow,” is a musculoskeletal condition characterized by pain around the lateral elbow and adjacent forearm with resisted wrist extension or passive terminal wrist flexion with the elbow in full extension, plus tenderness over and/or just distal to the lateral epicondyle. The name is a misnomer because the pathology is neither inflammatory nor located in the lateral epicondyle but rather represents a chronic tendinosis with disorganized tissue and neovessels of the tendon originating from the extensor carpi radialis brevis muscle and less commonly the extensor digitorum communis muscle, which originate on the lateral epicondyle. Clinical assessment involves understanding the chronology, precipitating activities, current symptoms, and interference with activities of daily living. Physical examination is performed bilaterally and includes palpitation provocative testing, measuring elbow and wrist motions, and neurological evaluation. Many treatments have been proposed, but little quality evidence supports any specific approach; more than 90% of cases are managed nonoperatively. Severe cases that have failed at least months of nonoperative management may warrant surgical assessment, but studies of surgical results for treatment of lateral epicondylitis are limited. Impairment rating may be necessary in a minority of cases and involves using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, based on diagnosis-based impairment and using Table 15-4, Elbow Regional Grid: Upper Extremity Impairments.

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B., Riyas Basheer K., Subhashchandra Rai, Irshana Balkies A. M., and Jasim Junaid N. P. "Incidence of tennis elbow and association of hand grip strength among college students." International Journal of Research in Medical Sciences 9, no. 1 (December 28, 2020): 177. http://dx.doi.org/10.18203/2320-6012.ijrms20205839.

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Background: Lateral epicondylitis is an overuse injury involving the origin of common extensor tendon at elbow joint. Among the college students there is more complaint on wrist and elbow. Objective was to find out the incidence of tennis elbow & grip strength among the students during the entire academic year.Methods: Three hundred and seventy subjects fulfilled the inclusion criteria with age respondents between seventeen to twenty four years. This study is done in those students who have local tenderness on palpation over the lateral epicondyle (grade 2). NPRS was used for measuring the pain intensity. Mill’s test and Cozen’s test was performed to confirm the tennis elbow. The subject is asked to squeeze the dynamometer three times with left and right hand respectively. There was one minute resting period between each squeeze were taken into account.Results: The incidence of confirmed tennis elbow was 4.05% & 2.70% in right and left respectively. Among those participants Mill’s test was positive in 16.2% on right and left side and Cozen’s test was positive in 8.1% on right side and 5.4% on left side. The mean rank of left and right grip strength for the students who are confirmed as tennis elbow were 52.75 Kg and 50.67 Kg and for not-confirmed were 36.56 Kg and 36.41 Kg respectively.Conclusions: The study concluded that 6.7% incidence rate of tennis elbow was observed in college students during the entire academic year. And also concluded there is no much significance correlation between grip strength and tennis elbow incidence rate.

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Nirschl, Robert P., Dennis M. Rodin, Derek H. Ochiai, and Craig Maartmann-Moe. "Iontophoretic Administration of Dexamethasone Sodium Phosphate for Acute Epicondylitis: A Randomized, Double-Blinded, Placebo-Controlled Study." American Journal of Sports Medicine 31, no. 2 (March 2003): 189–95. http://dx.doi.org/10.1177/03635465030310020601.

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Background: A better treatment modality is needed to control the pain of medial or lateral epicondylitis (tennis elbow). Hypothesis: Dermal iontophoretic administration of dexamethasone sodium phosphate will be significantly more effective in controlling pain than a placebo in patients with medial or lateral elbow epicondylitis. Study Design: Randomized, double-blinded, placebo-controlled study. Methods: On six occasions, 1 to 3 days apart within 15 days, 199 patients with elbow epicondylitis received 40 mA-minutes of either active or placebo treatment. Results: Dexamethasone produced a significant 23-mm improvement on the 100-mm patient visual analog scale ratings, compared with 14 mm for placebo at 2 days and 24 mm compared with 19 mm at 1 month. More patients treated with dexamethasone than those treated with placebo scored moderate or better on the investigator's global improvement scale (52% versus 33%) at 2 days, but the difference was not significant at 1 month (54% versus 49%). Investigator-rated pain and tenderness scores favored dexamethasone over placebo at 2 days. Patients completing six treatments in 10 days or less had better results than those treated over a longer period. Conclusions: Iontophoresis treatment was well tolerated by most patients and was effective in reducing symptoms of epicondylitis at short-term follow-up.

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Kohia, Mohamed, John Brackle, Kenny Byrd, Amanda Jennings, William Murray, and Erin Wilfong. "Effectiveness of Physical Therapy Treatments on Lateral Epicondylitis." Journal of Sport Rehabilitation 17, no. 2 (May 2008): 119–36. http://dx.doi.org/10.1123/jsr.17.2.119.

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Objective:To analyze research literature that has examined the effectiveness of various physical therapy interventions on lateral epicondylitis.Data Sources:Evidence was compiled with data located using the PubMed, EBSCO, The Cochrane Library, and the Hooked on Evidence databases from 1994 to 2006 using the key words lateral epicondylitis, tennis elbow, modalities, intervention, management of, treatment for, radiohumeral bursitis, and experiment.Study Selection:The literature used included peer-reviewed studies that evaluated the effectiveness of physical therapy treatments on lateral epicondylitis. Future research is needed to provide a better understanding of beneficial treatment options for people living with this condition.Data Synthesis:Shockwave therapy and Cyriax therapy protocol are effective physical therapy interventions.Conclusions:There are numerous treatments for lateral epicondylitis and no single intervention has been proven to be the most efficient. Therefore, future research is needed to provide a better understanding of beneficial treatment options for people living with this condition.

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Shaheen, Fareeda, Nazish Rafique, Aqsa Izhar Ahmed, and Perkash Lal. "COMPARATIVE ANALYSIS BETWEEN MOBILIZATION WITH MOVEMENT (MWM) AND MANIPULATION IN THE MANAGEMENT OF LATERAL EPICONDYLITIS." Pakistan Journal of Rehabilitation 5, no. 1 (January 1, 2016): 45–51. http://dx.doi.org/10.36283/pjr.zu.5.1/008.

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OBJECTIVES To compare the effect of Mobilization with Movement (MWM) and Manipulation in the management of lateral epicondylitis with regard to ache, grip power and functional activities. METHODOLOGY 20 patients presented with lateral epicondylitis (Tennis elbow) to OPD in Ziauddin Hospital (Clifton, North and Kemari campuses). They were enrolled for the purpose of research study after written informed consent. Subjects were erratically assigned into 2 groups, i.e. group A for MWM and group B for manipulation. All patients were examined before and after the treatment and then findings were evaluated. Pain was sedated by Visual analogue scale (VAS), grip strength was measured by hand–held dynamometer and functional activities’ outcomes were measured by forearm analysis questionnaire survey for lateral epicondylitis, by H B Leung et al 2004. RESULT A total of 20 patients were randomly selected and divided into two groups i.e. Group–A & Group–B. The result shows for Group A: The mean of pain score on VAS before treatment was 4.70±1.418 while after treatment was 0.10±0.316 with P value (0.05) and the mean of grip strength score before treatment was 13.40±7.442 while after treatment was 22.60±8.501. For Group B: The mean of pain score on VAS before treatment was 5.20±0.632 while after treatment was 0.5±0.527 with P value (0.05) and the mean of grip strength before treatment was 26.20±21.028 and after treatment was 32.00±24.33. CONCLUSION This study shows evidence to support the effectiveness of both approaches (MWM + Manipulation) for relieving ache, strengthening and functionality along with tennis elbow. KEYWORDS Lateral epicondylitis, Manipulation, Mobilization with movement (MWM), dynamometer, visual analog scale, and analysis.

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Poehling, Gary G. "Editorial Commentary: Elbow Lateral Epicondylitis (Tennis Elbow) Surgery Works, but Is Not Often Indicated." Arthroscopy: The Journal of Arthroscopic & Related Surgery 33, no. 6 (June 2017): 1269. http://dx.doi.org/10.1016/j.arthro.2017.02.020.

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DC, Gopal Sagar. "Effectiveness of Autologous Blood and Steroid Injection in Tennis Elbow Based on Visual Analog Score Pain Score and Nirschl Stage." Journal of Nepalgunj Medical College 18, no. 1 (December 31, 2020): 15–17. http://dx.doi.org/10.3126/jngmc.v18i1.35151.

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Introduction: Lateral epicondylitis or Tennis elbow is one of the most common causes of lateral elbow pain. Local steroid injection is a time tested treatment for providing symptomatic relief. Local injection of autologous blood in a case of lateral epicondylitis provides pain relief due to its cellular and humoral factor and triggers a healing cascade. Aims: This study aims to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow. Methods: This is a Hospital based study on conducted in the Department of Orthopedics at Nepalgunj Medical College from July 2018 to June 2019. 42 patients with unilateral tennis elbow were divided into two groups-Group A-21 patients (Autologous Blood Injection) and Group B-21 patients (Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg (in 2 ml) of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Visual Analogue Scale pain score and Nirschl stage of patients were evaluated before injection and at 2, 6, and 12 weeks of injection were noted and analyzed. Results: Preinjection mean VAS pain score was - 7.48±0.75, 7.52±0.68 in Group A, and Group B respectively while the Nirschl stage was 5.62±0.59 and 5.6±0.5 in group A and B, these scores among two group was not statistically significant. At 2 weeks follow up both groups showed improvement without any significant difference between two groups (p=0.84 and 0.549), while group A had better improvement in VAS pain score at 6 weeks (p=0.001). At 12 weeks follow-up within each group, there was significant VAS pain and Nirschl stage improvement (p=0.001) but there was no significant difference between the two groups. Conclusion: Injection of autologous blood and corticosteroid injection is equally effective in the treatment of Tennis elbow at 12 weeks final follow-up.

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Pote, Dr Uday B., Aishwarya Solge, Vaishnavi Karpe, Mihir A. Ghare, and Antara A. Thatte. "Comparative study of the Effectiveness of the use of the universal tennis elbow splint compared to elbow brace in treatment of Lateral Epicondylitis." VIMS Health Science Journal 7, no. 4 (December 17, 2020): 118–24. http://dx.doi.org/10.46858/vimshsj.7405.

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Background: Lateral epicondylitis is a serious condition affecting 1 to 3% of adult population between the age group of 30 to 50 year old. This group represents the working force and tennis elbow causes debilitating pain and patients are unable to perform the affected limb functions of lifting or holding anything. The main cause for tennis elbow is the tendinopathy of the extensor carpi radialis brevis muscle (ECRB). There are multiple treatment measures to relieve the pain and bring back the function of the limb to normalcy as early as possible. The elbow brace is used to reduce the expansion of the ECRB and thereby reducing the symptoms of tennis elbow. It was hypothesized that wrist splints would reduce the activation of the ECRB muscle and thereby will reduce the symptoms of the tennis elbow. Streek et al performed a study using the wrist splint with 20-30 degrees extension and mentioned in limitations the changing the degree of extension may improve outcomes as compared to elbow braces. On that hypothesis we used a brace with only 5-10 degrees of extension. Aims: 1) To study the symptomatic and functional outcome of the elbow brace. 2) To study the symptomatic and functional outcome of the wrist splint. 3) To compare the symptomatic and functional outcomes between the wrist splint and the elbow brace. Material & Methods: The patients included in the study were divided into Group A receiving the wrist splint and group B elbow brace. The patient rated tennis elbow evaluation score (PRTEE), grip strength and pain visual assisted (VAS) score on the day of enrolment and 6 weeks after using either the elbow brace or wrist splint was noted. We used Mann-Whitney U test to calculate P-value intergroup and for P-value intra-group we used Wilcoxon’s signed rank test. Result: Group A distribution of median 6 weeks PRTEE score improved significantly compared to median baseline PRTEE score (P-value<0.001). The VAS score, grip strength and improvement in PRTEE score at 6 weeks is relatively better in Group A compared to Group B, however the difference did not reach statistical significance (P-value>0.05).Conclusion: The use of wrist splint significantly improved the symptoms of the tennis elbow. The outcome is comparable to use of tennis elbow brace. The outcome is not statistically significant if compared between the two groups.

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Kitai, E., S. Itay, A. Ruder, J. Engel, and M. Modan. "An epidemiological study of lateral epicondylitis (Tennis elbow) in amateur male players." Annales de Chirurgie de la Main 5, no. 2 (January 1986): 113–21. http://dx.doi.org/10.1016/s0753-9053(86)80023-0.

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Titchener, Andrew G., Amol A. Tambe, Apostolos Fakis, Chris J. P. Smith, David I. Clark, and Richard B. Hubbard. "Study of Lateral Epicondylitis (Tennis Elbow) Using the Health Improvement Network Database." Shoulder & Elbow 4, no. 3 (July 2012): 209–13. http://dx.doi.org/10.1111/j.1758-5740.2012.00182.x.

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Dhage, Prasad. "Rehabilitation of Tennis Elbow (Lateral Epicondylitis) with Physical Therapy: A Case Report." Bioscience Biotechnology Research Communications 14, no. 6 (June 15, 2021): 81–83. http://dx.doi.org/10.21786/bbrc/14.6.19.

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Kadam, Rahul, Sachin Pandey, Abhay Chhallani, Santosh Pandhare, Abhishek Gupta, and Ritesh Sawant. "To evaluate the efficacy of platlet rich plasma injection in chronic lateral epicondylitis (tennis elbow)." International Journal of Research in Orthopaedics 3, no. 3 (April 25, 2017): 375. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20171466.

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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 at may increase the process of healing on a cellular level. The PRP increases the incorporation of cells, proliferation, and differentiation in tissue regeneration of the cell involved. This study was done to check the effectiveness of PRP injections in patients with chronic lateral epicondylitis or tennis elbow.Methods: This study was done on the patients visiting the orthopaedic OPD at MGM medical college and hospital, kamothe, Navi Mumbai. Total number of patients for this study was 40 out of which 32 were male and 8 were females. The mean age of the patients was 48.1years (range 17-82 years).Study period was 3 months. Stastical tool used is visual analog score.Results: Successful treatment was taken as more than 20% reduction i.e.(24 out of 40 patients) in visual analog score after 3 month. The mean VAS score was decreased from 6.98 to 4.91 after 3 months in males. While in females, mean VAS score was decreased from 6.66 to 5.22 after 3 months of PRP injection in lateral epicondylitis. Conclusions: Treatment of patients with PRP with chronic lateral epicondylitis or tennis elbow with PRP reduces pain and increases function of the affected elbow joint.

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Raeissadat, Seyed Ahmad, Leyla Sedighipour, Seyed Mansoor Rayegani, Mohammad Hasan Bahrami, Masume Bayat, and Rosa Rahimi. "Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial." Pain Research and Treatment 2014 (January 20, 2014): 1–8. http://dx.doi.org/10.1155/2014/191525.

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Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS), modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT) at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P>0.05). At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P<0.05). Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion.

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Gopinath, KM, Madhuram Chowdry, BNR Kumar, and TR Kanmani. "Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis." Journal of Medical Sciences 3, no. 1 (2017): 1–5. http://dx.doi.org/10.5005/jp-journals-10045-0045.

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ABSTRACT Introduction Tennis elbow is a common condition with unpromising several modalities of treatment. Many of these are not aimed at treating the disease process. Platelet-rich plasma (PRP) contains biological healing factors and shows promising results in tendinopathies. In this study, our aim was to evaluate the efficacy of autologous PRP vs steroid injection in the treatment of chronic recalcitrant lateral epicondylitis. Materials and methods A prospective randomized control trial was conducted in our tertiary care hospital. Sixty patients with chronic lateral humeral epicondylitis, not responding to oral medications, tennis elbow belt, and physiotherapy, aged between 18 and 60 years were included in the study. Patients were randomized into PRP or steroid injection group based on a computer-generated block randomization chart. All patients had a baseline assessment including visual analog pain scores, Disability assessment of Shoulder and Hand score (DASH), and Nirschl (Injury, Prevention, Cure and Care – Nirschl Pain Phase Scale of Athletic Overuse Injuries) scores, and the same was repeated at 2 weeks, 6 weeks, 3 months, and 6 months postintervention. Results Steroid treatment shows better outcome in short-term (p < 0.001) and PRP shows better outcome in long-term (p < 0.001) follow-up. All three scores – visual analog score (VAS), DASH, Nirschl – showed significant linear improvement with PRP treatment, whereas with steroid injection initially there was significant improvement up to 3 months and later recurrence of symptoms. No complications were noted with PRP injection. Conclusion Use of autologous PRP injections for the management of lateral epicondylitis has better long-term outcomes compared with steroid injection in terms of VAS, DASH, and Nirschl scores. Also in our trial we had no recurrence of symptoms in the PRP group, whereas pain recurred in six patients in steroid group and was treated successfully with PRP. How to cite this article Chowdry M, Gopinath KM, Kumar BNR, Kanmani TR. Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis. J Med Sci 2017;3(1):1-5.

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DERYABINA, Galina I., Viktoriya L. LERNER, Artem V. SAVELYEV, and Olga S. TERENTYEVA. "Physical rehabilitation after surgical treatment of epicondylitis of the elbow joint at the immobilization stage." Medicine and Physical Education: Science and Practice, no. 3 (2019): 60–66. http://dx.doi.org/10.20310/2658-7688-2019-1-3-60-66.

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The relevance of this topic is due to the fact that elbow joint epicondylitis is relatively common among athletes engaged in tennis, golf and species associated with throwing and throwing. When choosing the treatment method, several factors are taken into account: degree of elbow joint dysfunction; character of change of muscles and tendons in the zone of forearm and hand, as well as possibility of continuation of sports career. As a rule, in case of athletes' lateral and medial epicondylitis the choice is made in favor of surgical treatment, after which the limb is rigidly fixed for 2-3 weeks. The elbow joint is extremely sensitive even to short-term immobilization, which can lead to high mobility. Therefore, in order to avoid the development of elbow joint compression, the early beginning of the course of postoperative recovery measures carried out at the immobilization stage is necessary. We tried to develop the content of the course of physical rehabilitation of 25-30 years old athletes who underwent surgical treatment of epicondylitis for periods of absolute and relative immobilization, and experimentally justify its effectiveness. To assess the effectiveness of the developed physical rehabilitation course, we used tests to determine the functional-motor state of the forearm, operated arm; compared the obtained initial and final data.

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Gavhale, Sandeep, Harshit Dave, Hitesh Rohra, Vipul D. Shet, Ganesh Aher, and Sagar Bansal. "Tennis elbow brace and wrist cock-up splint in the management of tennis elbow: a comparative study." International Journal of Research in Orthopaedics 6, no. 4 (June 23, 2020): 813. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20202690.

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Background: The purpose of our study was to compare the efficacy of a wrist splint with a forearm counterforce strap brace in the management of tennis elbow.Methods: This prospective study was conducted between January and December 2018 comprising of 75 patients suffering from lateral epicondylitis managed conservatively with splints. Patients were randomized into three treatment groups, group 1 received tennis elbow forearm brace, group 2 received wrist extension splint, group 3 received both tennis elbow forearm brace and wrist extension splint. The patient-rated tennis elbow evaluation (PRTEE) score and visual analogue scale (VAS) scores were calculated at 0, 3 and 6 weeks of the treatment.Results: Mean difference of pre-treatment and post-treatment PRTEE score was significant in all three groups and was maximum for group 3 patients (32.42) followed by group 2 patients (27.04) followed by group 1 patients (20.06). Pre-treatment and post-treatment VAS score difference was maximum for group 3 patients.Conclusions: Significant symptomatic relief can be achieved in patients with tennis elbow by using either tennis elbow forearm brace or wrist extension splint or both. Provided proper patient selection and compliance, wrist extension splint achieves better symptomatic relief and functional outcome as compared to tennis elbow brace.

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Journal articles on the topic 'Lateral epicondylitis (tennis elbow)'

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