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Conservative therapy for tennis elbow.

E Ernst1

  • 1Department of Physical Medicine and Rehabilitation, Medical School, University of Vienna.

The British Journal of Clinical Practice
|January 1, 1992
PubMed
Summary
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Tennis elbow, an overuse injury affecting the extensor carpi radialis brevis muscle, is best diagnosed clinically. Initial treatments focus on physical methods, with surgery reserved for persistent symptoms.

Area of Science:

  • Orthopedics
  • Sports Medicine
  • Physical Therapy

Background:

  • Tennis elbow (lateral epicondylitis) is a prevalent overuse injury.
  • Characterized by degenerative changes in the extensor carpi radialis brevis enthesis.
  • Clinical diagnosis involves excluding other causes of lateral elbow pain.

Purpose of the Study:

  • To review current diagnostic and treatment strategies for tennis elbow.
  • To evaluate the efficacy of various physical and medical interventions.
  • To highlight areas requiring further research.

Main Methods:

  • Clinical diagnosis through differential assessment.
  • Review of evidence for physical therapies: ultrasound, low-energy laser, electrotherapy, thermotherapy, massage.

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  • Assessment of outcomes for steroid injections and surgical interventions.

    • Main Results:

    • Ultrasound demonstrated efficacy in placebo-controlled trials.
    • Low-energy laser showed objective symptom improvement but not subjective relief.
    • Physical therapies like electrotherapy, thermotherapy, and massage require more robust evidence.
    • Steroid injections offer relief when physical treatments fail; surgery is a last resort.

    Conclusions:

    • Conservative physical treatments are the recommended first-line approach for tennis elbow.
    • Evidence supports ultrasound and low-energy laser, though further research is needed for other modalities.
    • A stepwise treatment approach, from physical therapy to surgery, is generally effective.
    • Continued research is essential to address remaining questions regarding this common soft tissue condition.