The Immediate Effects of Orthoses on Pain in People with Lateral Epicondylalgia

Abstract

Objective. Tennis elbow is a common cause of upper limb dysfunction and a primary reason for pain at the lateral aspect of the elbow. The purpose of this study was to investigate the effects of three commonly used orthoses on pain severity. An elbow band, an elbow sleeve, and a wrist splint were assessed for their ability to reduce the level of reported pain. Method. A crossover randomized controlled trial was used. The orthoses were worn in a randomized order, and all participants were required to complete a control trial for which they wore a placebo orthosis. 52 participants with lateral epicondylalgia were recruited, and the level of pain at their elbow was recorded using the visual analogue scale (VAS). Results. The reported pain for all orthoses was lower than that of the placebo (P < 0.05). Pain reduction was significantly greater with a counterforce elbow band or a counterforce elbow sleeve compared to a wrist splint (P < 0.01). There was no significant difference between a counterforce elbow band and a counterforce elbow sleeve (P = 0.23). Conclusion. All the types of orthoses studied showed an immediate improvement on pain severity in people with lateral epicondylalgia. The counterforce elbow orthoses (elbow band and elbow sleeve) presented the greatest improvement, suggesting that either of them can be used as a first treatment choice to alleviate the pain in people with tennis elbow.

A Newly Designed Tennis Elbow Orthosis With a Traditional Tennis Elbow Strap in Patients With Lateral Epicondylitis

“…The findings demonstrated that both of the studied counterforce braces reduced pain and increased grip force in individuals with lateral epicondylitis, when assessed immediately after application. This finding is similar to other studies ( 10 , 12 , 14 , 15 ). However, our newly designed brace was significantly better at reducing pain and improving grip strength ( Table 2 ).…”

“…In their study, Jafarian and colleagues used a double-layered pressure pad in the elbow strap, and found that the sleeve, which applied generalized compression around the elbow area rather than specifically to the area distal to the lateral epicondyle, increased pain-free grip strength, suggesting that specific compression may not be necessary ( 14 ). Sadeghi-Demneh and Jafarian compared the immediate results of an elbow counterforce band, an elbow counterforce sleeve, and a wrist splint with a placebo, and found that the elbow counterforce orthosis was more effective than the wrist splints ( 15 ). These authors reported that applying a counterforce orthosis at the elbow (either a strap or sleeve) improved pain-free grip strength in individuals with lateral epicondylitis when tested immediately after application.…”

“…In this non-randomized double-blind clinical trial, 12 participants with lateral epicondylitis (six men and six women), aged 31 to 55 years (mean 46.33 years) were chosen to participate. All participants had symptoms of lateral epicondylitis for at least six weeks, and had at least three positive results out of four diagnostic tests for tennis elbow ( 15 ). They had not used any other treatments for tennis elbow, including steroid injections.…”

“…Nirschl ( 11 ) and Wadsworth et al ( 12 ) supported the theory that pressure from the brace on the extensor muscles can lessen muscle-tendon tension in the lateral epicondylar region ( 13 ). Counterforce braces have immediate positive effects on the symptoms of tennis elbow, placing pressure on the origins of muscle tendons, especially the ECRB and extensor digitorum communis ( 12 - 15 ). Hence, we decided to design and fabricate a new orthosis that more effectively reduces the tension of the extensor tendon origin compared to the traditional tennis elbow strap.…”

Conservative treatment of lateral epicondylitis: The impact of psychosocial factors on perceived treatment efficacy

“…A similar comparison by Altan and colleagues demonstrated statistically significant improved pain ratings with rest and movement at 2 and 6 weeks following treatment with a wrist splint [13]. Sadeghi-Demneh evaluated the immediate effect of various orthoses on pain severity associated with lateral epicondylitis and found that a wrist splint offered statistically significant improvement in pain levels compared to placebo [23]. The reason for the immediate pain relief is hypothesized to be due to decreased activity of the involved musculotendinous units that alleviates dynamic compression at their origin.…”