Background: Epicondylopathia humeri radialis is often diagnosed by general practitioners. Usually, the therapy comprises transcutaneous electrical nerve stimulation and the application of a forearm brace. Manual therapy is prescribed beyond transcutaneous electrical nerve stimulation and forearm brace, and it is performed by specialized physiotherapists. However, data comparing the effectiveness of all methods are scarce. In this study, the therapeutic effects of manual therapy were compared to those of transcutaneous electrical nerve stimulation and forearm brace along with a combination of all three. Methods: Fifty-two patients diagnosed with epicondylopathia humeri radialis by a general practitioner were randomized into three treatment arms: 19 patients received a combination of manual therapy, transcutaneous nerve stimulation, and forearm brace; 18 patients received manual therapy only; and 15 patients wore a forearm brace and received transcutaneous nerve stimulation. The primary outcomes included the range of motion and pain intensity. The secondary outcomes were elbow function and psychological well-being. Primary and secondary outcomes were measured before treatment (0), and 4- and 8-weeks post-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 between the intervention groups.Conclusions: Manual therapy alone is as effective as combination therapy with transcutaneous nerve stimulation and the use of a forearm brace for epicondylopathia humeri radialis. Hence, there is evidence supporting the inclusion of manual therapy in the guidelines for treating patients with epicondylopathia humeri radialis. Trial registration: German Clinical Trial Register: DRKS, trial registration number: 00021137, date of registration: 24/03/2020 (retrospectively registered)
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.
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