Manual therapy and exercise for lateral elbow pain

Area of Science:

• Orthopedics
• Physical Therapy
• Evidence-Based Medicine

Background:

• Lateral elbow pain is commonly treated with manual therapy and prescribed exercises.
• The combined or separate efficacy of these treatments requires thorough evaluation.

Purpose of the Study:

• To assess the benefits and harms of manual therapy, prescribed exercises, or both for adults experiencing lateral elbow pain.

Main Methods:

• Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
• Searched multiple databases (CENTRAL, MEDLINE, Embase) and trial registries up to January 2024.
• Assessed pain, disability, quality of life, treatment success, withdrawals, and adverse events using GRADE methodology.

Main Results:

• Low-certainty evidence suggests manual therapy may reduce pain and disability in the short term compared to placebo.
• Manual therapy and/or exercises showed slight, possibly not clinically worthwhile, reductions in pain and disability, with benefits not sustained.
• Evidence regarding health-related quality of life, treatment success, and adverse events remains uncertain due to low certainty and potential biases.

Conclusions:

• Manual therapy may offer short-term pain and disability relief for lateral elbow pain, but evidence is limited and long-term effects are unknown.
• The benefits of manual therapy and prescribed exercises for lateral elbow pain may be small and not sustained over time.
• Further high-quality research is needed to clarify the efficacy and long-term outcomes of these interventions.