Trial of Physiotherapy and Corticosteroid Injections in Lateral Epicondylalgia
This randomised controlled trial will evaluate the role of manual therapy and therapeutic exercise and corticosteroid injections in the treatment of lateral epicondylalgia (tennis elbow).
Procedure: Manual therapy and therapeutic exercise
Procedure: Corticosteroid injections
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind
Primary Purpose: Treatment
|Official Title:||A Pragmatic, Randomised Controlled Trial of Physiotherapy and Corticosteroid Injections in Lateral Epicondylalgia|
- General improvement
- Assessors assessment of severity
- Pain free grip strength
- Global perceived effect score
- Pain Visual Analogue Scale
- Function Visual Analogue Scale
- Impact on occupational and recreational activities
- Stratford pain free function questionnaire
- Patient rated evaluation questionnaire
- Pressure pain threshold
- Maximum grip strength
- Pain visual analogue scale with gripping
- Tests of motor control (reaction time, speed, accuracy, coordination)
|Study Start Date:||March 2002|
|Study Completion Date:||September 2006|
|Primary Completion Date:||September 2006 (Final data collection date for primary outcome measure)|
Musculoskeletal conditions account for the third leading cause of health systems expenditure in Australia. Lateral epicondylalgia (tennis elbow) is a painful musculoskeletal condition that is often treated in primary care. Seven out of every 1000 patients seeing their general medical practitioner do so for this condition, though most are not tennis related. On average 10-30% of sufferers take 12 weeks of absenteeism from work and the condition may last 6-48 months.
Two popular treatment options that are commonly prescribed for the management of lateral epicondylalgia are manual therapy/therapeutic exercise and corticosteroid injections. To date there is little evidence that supports manual therapy/therapeutic exercise. This lack of evidence is largely due to the small number of studies of physiotherapy treatments, most of which are of poor quality. The small number of studies of manual therapy contrasts with the larger number of studies of corticosteroid injections, which show that corticosteroid injections are beneficial in the short term (3-6 weeks), but they are associated with significantly greater recurrence rates and offer no advantage in the long term (12 months). The efficacy of a manual therapy and therapeutic exercise programme compared to that of corticosteroid injections is unknown at this stage.
This randomised controlled trial will evaluate the role of manual therapy and therapeutic exercise in the treatment of lateral epicondylalgia. The factors associated with success or failure of these common treatment options for lateral epicondylalgia will also be examined. A tangible outcome of this project will be the development of clinical guidelines for the most effective method of treating lateral epicondylalgia.
|Musculoskeletal Pain & Injury Research Unit, Division of Physiotherapy, The University of Queensland|
|Brisbane, Queensland, Australia, 4072|
|Principal Investigator:||Dr Bill Vicenzino, PhD||The University of Queensland|