More Power to your Elbow!

Diagnoses and treatment

Many tests exist to determine the cause of lateral elbow pain. Langford presents three and reports on the specificity and sensitivity of each. We’ve extensively covered tendinopathy in recent articles, and the treatment of LE follows the same protocol of eccentric exercise and slow, heavy resisted movement. Begin exercise therapy once LE is confirmed. Supporting this approach, a Swedish study found tendon loading, via eccentric exercise, resulted in significant pain relief in subjects with LE⁽¹⁾.

Other therapies often tried with LE include injection therapy, bracing, and taping. Researchers in Ontario reviewed the literature concerning the effectiveness of injection therapy on LE⁽²⁾. Concerning treatment using needle tenotomy, autologous whole blood, and platelet rich plasma, the studies contained bias and design flaws. The research also failed to support treatment of LE with corticosteroid injections.

Elbowing in one more study

Kinesio taping has gotten a lot of negative press lately because science hasn’t supported the hype and claims of its manufacturers. Some practitioners aren’t ready to throw in the towel yet, including several at Taipei Medical University. They conducted a randomized, double-blinded, crossover study to test its effectiveness in relieving acute pain in LE⁽³⁾. They found that both the sham and Kinesio tape resulted in pain relief at rest and improved pain-free grip strength. However, the Kinesio tape did provide significantly better pain relieve on resisted wrist extension.

This study, while well designed, consisted of only 15 elbows. Additionally, there was enough evidence of the placebo effect in the parameters measured, that the significant difference should be viewed with skepticism. For the time being, the best approach to treating LE continues to be exercise.

References

1. Scand J Med Sci Sports, 2012, 22, 797 – 803
2. J Clin Rheumatol.2018 Aug 3 [Epub ahead of print]
3. BMC Musculoskeletal Dis. 2018;19:193