Conservative treatment of lateral epicondylitis: comparison of two different orthotic devices

Abstract

We investigated the effectiveness of braces in the treatment of lateral epicondylitis and compared the effects of two different types of most frequently used braces. A total of 50 patients (seven males and 43 females) with an age range of 34 to 60 who had the diagnosis of lateral epicondylitis were included in the study. The patients were distributed into two groups. In group I, 25 patients (21 females and four males) were given a lateral epicondyle bandage. In group II, 25 patients (22 females and three males) were given a wrist resting splint holding the wrist in slight dorsiflexion. Evaluations of the patients were done before treatment and at the second and sixth weeks of treatment. Evaluation parameters were pain during rest and movement, sensitivity, algometer score, hand grip strength, and evaluation of the response to treatment. The response to treatment was evaluated according to the following categories: excellent, good, medium, and bad. In group I, only pain during rest and movement significantly decreased at 2 weeks while significant improvement was obtained for all parameters at 6 weeks. In group II, all parameters except for algometric sensitivity showed significant improvement at 2 weeks. Significant improvement was obtained for all parameters at 6 weeks in this group. Comparison of the two groups showed significantly better improvement in resting pain in group II at 2 weeks while there was no difference for other parameters including response to treatment at either evaluation stage. Braces might be a good strategy to help wait out the natural course of tennis elbow complaints. Although epicondyle bandage was not found to be superior to wrist splint in our study, we may suggest that it could be favored over splint since it is more practical and cosmetically acceptable.

Immediate Effects of 2 Types of Braces on Pain and Grip Strength in People With Lateral Epicondylalgia: A Randomized Controlled Trial

“…Overall, despite variations in study designs, timing of outcomes, type of brace, and comparator groups, 5 most studies have shown that elbow or forearm braces improve pain and function in people with lateral epicondylalgia. 2,13,18,32 Although the results of our study found an improvement between prebracing and postbracing measures, overall, the brace conditions were no more effective than the control at improving immediate outcomes. As such, it appears that the additional strap on the forearm-elbow brace does not improve the efficacy of the existing forearm brace to immediately relieve pain or improve function.…”

Effects of Therapeutic Eccentric Exercise on Pain and Grip Strength in Persons with Lateral Epicondylitis: A Randomized Controlled Trial

“…Most typically, the primary pathology in tendinosis of the extensor carpi radialis brevis (ECRB) tendon 1-2 cm dista to its attachment on the lateral epicondyle [Altan, 2008;Jafarian, 2009]. In general, microscopic evaluation of the tendons does not show signs of inflammation, but rather angiofibroblastic degeneration and collagen disarray.…”

Functional outcome after autologous blood injection for tennis elbow

“…16 In spite of many studies suggesting non inflammatory but degenerative nature of tennis elbow still many orthopedic surgeons often inject corticosteroids for tennis elbow. [7][8][9] Current literature suggests injection of corticosteroids gives only short term pain relief and in the midterm and long term follow up it has no role. 17 Biologically, corticosteroids do not address the underlying pathobiology of tendinopathy but rather have deleterious effect and may result in induction of cell apoptosis and breakdown of collagen and matrix.…”

“…19 Chemical modifiers of cellular activity like FGF, PDGF, and TGF are carried in the blood and are known to be mitomorphogenic. 7 Autologous blood injection delivers blood borne cellular and humoral mediators to stimulate the regeneration process within the tendon. 15 Introducing autologous blood in a relatively atraumatic manner may initiate the inflammatory cascade and promote healing in an otherwise degenerative process.…”