In this article, we will discuss the rationale behind the treatment of lateral epicondylitis.
Lateral epicondylitis is a common condition and is said to be more likely to occur in people in their 30s~50s.
It is sometimes referred to as "tennis elbow" because it tends to occur in racquet sports such as tennis, and depending on the level of pain, it can interfere with daily life.Therefore, you may try various methods to manage the pain, but this time I will introduce the rationale behind conservative therapy, which is easy to use.
How reliable is it? How much can we expect? How reliable is it?
Risk Factors
If you have pain on the outside of your elbow, you may suspect lateral epicondylitis, but risk factors include
People who work with their forearms in the rotated position.
There is no significant difference in morbidity between those who do light work and those who handle heavy cargo, except for the difference in severity.
People with hyperglycemia
Racquetball players with weak trapezius and wrist dorsiflexor muscle groups
Racquetball players with high BMI
Epidemiological studies have shown that people with these conditions are more likely to be affected.
Are tennis bands useful?
Some studies have shown that the effectiveness of tennis bands in eliminating pain is limited by the evidence.
One study compared tennis bands to a stretching group and found that both groups were helpful in reducing pain, but after 9 months, the stretching group showed significant improvement.This is not to say that there is no point in using the tennis band, but it is unlikely that the tennis band alone will eliminate pain.
Is physical therapy useful?
Among the conservative treatments for this syndrome, physical therapy is classified as highly recommended, and in some observational studies of medium-term interventions, it has shown significant results compared to other treatments.
The comparison with tennis bands was mentioned above, and when compared with steroid injections, steroid injections have more significant results in pain relief in the short term.However, since there may be no reduction in pain after the injection, physical therapy is considered to be more useful as a medium-term intervention.
Physical therapy includes stretching, massage, and physical therapy, but in the literature referenced, only stretching was found to be useful.
There is little in the literature to support the effectiveness of long-term interventions (up to a year), and many studies suggest that it is better to assume a short- to medium-term period for the effectiveness of physical therapy.
Is acupuncture useful?
There is a paucity of research supporting acupuncture, and while some studies have shown changes in things that are troubling due to symptoms, such as pain reduction, increased grip strength, etc., there are no results showing that acupuncture is superior to manual therapy when compared to manual therapy.
However, when compared to the placebo group, the results were in favor of acupuncture.
Based on these results, is acupuncture the preferred choice of intervention? It is not recommended.
Is extracorporeal shock wave therapy useful?
According to a study of extracorporeal shock wave therapy that evaluated pain at rest and under load, it can reduce pain in the short term, but is it useful in the medium term? According to the results of the evaluation of pain at rest and under load, pain reduction is expected in the short term, but is it useful in the medium term?
Studies that followed patients from six months to a year later showed no useful results.There are also reports of adverse events such as mild skin redness and mood swings.
Although I wrote "mild", it is not a highly recommended method due to the concerns of some patients who wish to withdraw from the procedure and bone invasiveness.
Conclusion
This is the result of a typical conservative therapy.
These results are based on meta-analyses and randomized comparative studies, so they can be said to be reliable, but it is difficult to say that they are true for everyone.However, it is difficult to say that this is the case for everyone. Some people are quite happy with the non-recommended methods.
If I had lateral epicondylitis of the humerus, I would stretch and see how it goes, and if there were no results in the VAS or various tests after a week of doing it, I would do a steroid injection.
If it comes to that, surgery! I'd like to say "surgery", but since there are cases of poor surgery and recurrence, I'd like to do something with conservative therapy.
I would like to say "surgery if necessary!
