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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2023; 33(02): 79-86
DOI: 10.1055/a-1870-3073
Original Article

Therapeutic Effects of Manual Therapy on Lateral Epicondylitis: A Randomised Controlled Trial

Therapeutische Effekte manueller Therapie bei lateraler Epicondylitis: Eine randomisierte kontrollierte Studie
Wolfgang Rachold 
1   Practice for General Medicine, Salvador-Allende-Straße Rostock, Germany
,
Olaf Reis 
2   Department for Child and Adolescence Neuropsychiatry, University of Rostock, Gehlsheimer Straße Rostock, Germany
,
Christoph Berger 
2   Department for Child and Adolescence Neuropsychiatry, University of Rostock, Gehlsheimer Straße Rostock, Germany
,
Johannes Buchmann 
2   Department for Child and Adolescence Neuropsychiatry, University of Rostock, Gehlsheimer Straße Rostock, Germany
3   Practice for Neurology and Psychiatry, Gehlsheimer Straße Rostock, Germany
› Author Affiliations Funding The study received no support, including funding, grants, or equipment. To publish this study, the authors did not receive any financial benefits.
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Abstract

Background Epicondylopathia humeri radialis is often diagnosed by general practitioners. Usually, the therapy comprises transcutaneous electrical nerve stimulation using a forearm brace. Manual therapy, performed by specialised physiotherapists, is prescribed before transcutaneous electrical nerve stimulation and forearm brace use. However, studies comparing the effectiveness of all methods are scarce.

Objective To compare the therapeutic effects of manual therapy, transcutaneous electrical nerve stimulation, and forearm brace use, as well as the combination of all three.

Methods Fifty-two patients diagnosed with epicondylopathia humeri radialis were randomised into three treatment arms: a combination of manual therapy, transcutaneous nerve stimulation, and forearm brace use (n=19); manual therapy only (n=18); and a combination of forearm brace use and transcutaneous nerve stimulation (n=15). All measurements and therapies, excluding manual therapy, were performed at the first author’s practice premises. The primary outcomes included range of motion and pain intensity; the secondary outcomes were elbow function and psychological well-being. Primary and secondary outcomes were measured before and at 4 and 8 weeks after treatment using the Patient Rated Tennis Elbow Evaluation Questionnaire and the Short Form Health Survey Questionnaire.

Results The range of motion and pain intensity did not differ among the groups.

Conclusion Manual therapy alone was as effective as the combination of transcutaneous nerve stimulation and forearm brace use for epicondylopathia humeri radialis. Our findings support the inclusion of manual therapy as a stand-alone therapy option in the guidelines for treating patients with epicondylopathia humeri radialis.

Zusammenfassung

Hintergrund Epicondylopathia humeri radialis wird häufig von Hausärzten diagnostiziert. Die Therapie erfolgt oft mit transkutaner, elektrischer Nervenstimulation oder einer Epicondylitisspange. Darüber hinaus wird manuelle Therapie, ausgeführt durch darin ausgebildete Physiotherapeuten, durch Ärzte rezeptiert. Studien, die die Wirksamkeit dieser Methoden vergleichen, sind rar.

Fragestellung Vergleich der therapeutischen Wirkungen von manueller Therapie, transkutaner elektrischen Nervenstimulation und Epicondylitisspangen, sowie deren Kombination.

Methoden Zweiundfünfzig Patienten, bei denen Epicondylopathia humeri radialis diagnostiziert wurde, wurden in drei Behandlungsarme randomisiert: eine Kombination aus manueller Therapie, transkutaner Nervenstimulation und Verwendung von Epicondylitisspangen (n=19); nur manuelle Therapie (n=18); und eine Kombination aus Epicondylitisspange und transkutaner Nervenstimulation (n=15). Alle Messungen und Therapien, mit Ausnahme der manuellen Therapie, wurden in den Praxisräumen des Erstautors durchgeführt. Zu den primären Outcomes gehörten der Bewegungsumfang des Ellenbogengelenkes und die Schmerzintensität; Die sekundären Outcomes waren die Ellenbogenfunktion und das psychische Wohlbefinden unter Verwendung des Patient Rated Tennis Elbow Evaluation Fragebogens und der Short Form Health Survey Fragebogens. Die primären und sekundären Outcomes wurden vor und nach 4 und 8 Wochen nach der Behandlung ermittelt.

Ergebnisse Der Bewegungsumfang und die Schmerzintensität unterschieden sich nicht zwischen den Gruppen.

Schlussfolgerung Die manuelle Therapie allein war ebenso wirksam wie die Kombination aus transkutaner Nervenstimulation und Epicondylitisspange bei Epicondylopathia humeri radialis. Unsere Ergebnisse unterstützen die Aufnahme der manuellen Therapie als eigenständige Therapieoption in die Leitlinien zur Behandlung von Patienten mit Epicondylopathia humeri radialis.

Key words

Musculoskeletal Manipulations - Tennis Elbow - Trigger Points - Elbow Joint - General Practice - Tendinopathy

Schlüsselwörter

trigger points - musculoskeletal diseases - musculoskeletal pain


Publication History

Received: 11 May 2022

Accepted: 07 June 2022

Article published online:
14 July 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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