ChiroACCESS Clinical Review



Tennis Elbow: Therapy

This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Lead Author(s): 

Dwain M. Daniel, D.C.

  

How this evidence was rated:

Strength of Recommendation Taxonomy (SORT)



Published on

December 1, 2006

Text Size:     
One surgeon states in his review of lateral epicondylitis (LE) treatments, “non-operative therapeutic modalities…are unproven at best”. When it comes to surgery he is also concerned about a lack of surgical evidence, yet finds it proper for the surgeon to be “guided by simply our subjective viewpoint” (1). This paper asks in its title “Is there any science out there?” and that is the heart of the problem when it comes to LE treatment. Good quality randomized controlled trials (RCT) are rare. As with the surgeon, the non-surgical physician must judge what is an acceptable intervention based on “best judgment” using limited scientific evidence.

The reader should note there is no treatment option that has clearly demonstrated efficacy through rigorous clinical trials.

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References

1. 

Boyer MI, Hastings H. Lateral tennis elbow: "Is there any science out there?". J Shoulder Elbow Surg 1999; 8(5):481-491.



2. 

Struijs PA, Damen PJ, Bakker EW, Blankevoort L, Assendelft WJ, van Dijk CN. Manipulation of the wrist for management of lateral epicondylitis: a randomized pilot study. Phys Ther 2003; 83(7):608-616.



3. 

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4. 

Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ 2006; 333(7575):939.



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6. 

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12. 

Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med 2005; 39(7):411-422.



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14. 

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15. 

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16. 

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17. 

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18. 

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21. 

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22. 

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23. 

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24. 

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25. 

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27. 

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28. 

Smidt N, Assendelft WJ, van der Windt DA, Hay EM, Buchbinder R, Bouter LM. Corticosteroid injections for lateral epicondylitis: a systematic review. Pain 2002; 96(1-2):23-40.



29. 

Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ 2006; 333(7575):939.



30. 

Buchbinder R, Green SE, Youd JM, Assendelft WJ, Barnsley L, Smidt N. Systematic review of the efficacy and safety of shock wave therapy for lateral elbow pain. J Rheumatol 2006; 33(7):1351-1363.



31. 

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32. 

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33. 

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