The online version of this article (doi:10.1186/s12891-015-0665-4) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
CW and VL designed the study; CW, KN, KG and VL analyzed the data; VL, KN, KG and OC collected data; CW and VL wrote the first draft of the paper; KN, KG, OC contributed to the writing of the paper; CW contributed to analysis and interpretation of the data; CW and KN contributed to the discussions on the design and interpretation of the study. CW and OC conducted final revisions. All authors read and approved the final manuscript.
Physical therapy for the treatment of lateral epicondylitis (LE) often comprises movement therapies, extracorporeal shockwave therapy (ECSWT), low level laser therapy (LLLT), low frequency electrical stimulation or pulsed electromagnetic fields. Still, only ECSWT and LLLT have been meta-analytically researched.
PUBMED, EMBASE and Cochrane database were systematically searched for randomized controlled trials (RCTs). Methodological quality of each study was rated with an adapted version of the Scottish Intercollegiate Guidelines Network (SIGN) checklist. Pain reduction (the difference between treatment and control groups at the end of trials) and pain relief (the change in pain from baseline to the end of trials) were calculated with mean differences (MD) and 95 %-Confidence intervals (95 % CI).
One thousand one hundred thirty eight studies were identified. One thousand seventy of those did not meet inclusion criteria. After full articles were retrieved 16 studies met inclusion criteria and 12 studies reported comparable outcome variables. Analyses were conducted for overall pain relief, pain relief during maximum handgrip strength tests, and maximum handgrip strength. There were not enough studies to conduct an analysis of physical function or other outcome variables.
Differences between treatment and control groups were larger than differences between treatments. Control group gains were 50 to 66 % as high as treatment group gains. Still, only treatment groups with their combination of therapy specific and non-therapy specific factors reliably met criteria for clinical relevance. Results are discussed with respect to stability and their potential meaning for the use of non-therapy specific agents to optimize patients’ gain.
Additional file 1: Overall pain reduction for physical therapy groups. (PDF 332 kb)12891_2015_665_MOESM1_ESM.pdf
Additional file 2: Overall pain reduction in ECSWT groups. (PDF 267 kb)12891_2015_665_MOESM2_ESM.pdf
Additional file 3: Pain reduction in Non-ECSWT groups. (PDF 274 kb)12891_2015_665_MOESM3_ESM.pdf
Additional file 4: Pain during grip strength test relief in LLLT groups. (PDF 240 kb)12891_2015_665_MOESM4_ESM.pdf
Additional file 5: Pain during maximum grip strength test relief in LLLT-sham groups. (PDF 243 kb)12891_2015_665_MOESM5_ESM.pdf
Additional file 6: Pain during maximum handgrip strength test reduction in LLLT groups. (PDF 245 kb)12891_2015_665_MOESM6_ESM.pdf
Additional file 7: Maximum grip strength gain in treatment groups (LLLT and ECSWT). (PDF 233 kb)12891_2015_665_MOESM7_ESM.pdf
Additional file 8: Maximum grip strength gain in sham-groups (associated with LLLT and ECSWT). (PDF 231 kb)12891_2015_665_MOESM8_ESM.pdf
Additional file 9: Differences between treatment and sham-groups in maximum handgrip strength at the end of treatment (LLLT and ECSWT). (PDF 235 kb)12891_2015_665_MOESM9_ESM.pdf
Buchbinder R, Green S, Struijs P. Musculoskeletal disorders: tennis elbow. Clin Evid. 2008;05:1117–37.
NGC-8513. Work Loss Data Institute. Elbow (acute & chronic). Encinitas (CA): Work Loss Data Institute; 2011.
Ho LOL, Kwong WL, Cheing GLY. Effectiveness of microcurrent therapy in the management of lateral epicondylitis: a pilot study. Hong Kong Physiother J. 2007;25:14–20. CrossRef
Martinez-Silvestrini JA, Newcomer KL, Gay RE, Schaefer MP, Kortebein P, Arendt KW. Chronic lateral epicondylitis: comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening. J Hand Ther. 2005;18:411–20. CrossRefPubMed
Nourbakhsh MR, Fearon FJ. An alternative approach to treating lateral epicondylitis. A randomized, placebo-controlled, double-blinded study. Clin Rehabil. 2008;22:601–9. CrossRef
Rompe JD, Hopf C, Küllmer K, Heine J, Bürger R. Low-energy extracorporeal shock wave therapy for persistent tennis elbow. J Bone Joint Surg. 1996;78:233–7.
Staples MP, Forbes A, Ptasznik R, Gordon J, Buchbinder R. A randomized controlled trial of extracorporeal shock wave therapy for lateral epicondylitis (Tennis Elbow). J Rheumatol. 2008;35:2038–46. PubMed
Sterigioulas A. Effects of low-level laser and plyometric exercises in the treatment of lateral epicondylitis. Photomed Laser Surg. 2007;25:205–13. CrossRef
Crowther MAA, Bannister GC, Huma H, Rooker GD. A prospective, randomized study to compare extracorporeal shock-wave therapy and injection of steroid for the treatment of tennis elbow. J Bone Joint Surg. 2002;84-B(5):678–9. CrossRef
Levitt RL, Selesnick H, Ogden J. Shockwave therapy for chronic lateral epicondylitis - an FDA study, Paper presented at: AOSSM Specialty Day, AAOS Annual Meeting. San Francisco: Calif; 2004.
Haker E, Lundeberg T. Lateral epicondylalgia: report of noneffective midlaser treatment. Arch Phys Med Rehabil. 1991;72:984–8. PubMed
Lundeberg T, Haker E, Thomas M. Effect of laser versus placebo in tennis elbow. Scand J Rehab Med. 1987;19:135–8.
Papadopoulos ES, Smith RW, Cawley MID, Mani R. Low-level laser therapy does not aid the management of tennis elbow. Clin Rehabil. 1996;10:9–11. CrossRef
Vasseljen O, Høeg N, Kjeldstad B, Johnsson A, Larsen S. Low level laser versus placebo in the treatment of tennis elbow. Scand J Rehab Med. 1992;24:37–42.
Altman RD, Zinsenheim JR, Temple AR, Schweinle JR. Three-month efficacy and safety of acetaminophen extended-release for osteoarthritis pain of the hip or knee: a randomized, double-blind, placebo-controlled study. Osteoarthitis Cartilage. 2007;15:454–61. CrossRef
Grifka JK, Zacher J, Brown JP, Seriolo B, Lee A, Moorem A, et al. Efficacy and tolerability of lumiracoxib versus placebo in patients with osteoarthritis of the hand. Clin Exp Rheumatol. 2004;22:589–96. PubMed
Leung AT, Malmstrom K, Gallacher AE, Sarembock B, Poor G, Beaulieu A, et al. Efficacy and tolerability profile of etoricoxib in patients with osteoarthritis: a 13-week randomized, double-blind, placebo and active- comparator controlled 12-week efficacy trial. Curr Med Res Opin. 2002;18(2):49–58. CrossRefPubMed
Schnitzer TJ, Gray WL, Paster RZ, Kamin M. Efficacy of tramadol in treatment of chronic low back pain. J Rheumatol. 2000;27:772–8. PubMed
Tannenbaum H, Berenbaum F, Reginster JY, Zacher J, Robinson J, Poor G, et al. Lumiracoxib is effective in the treatment of osteoarthitis oft the knee: a 13 week, randomized, double blind study versus placebo and celecoxib – osteoarthritis-pain-intensity-scale. Ann Rheum Dis. 2004;63:1419–26. CrossRefPubMedPubMedCentral
- Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
Mail Icon II