Tennis elbow (lateral epicondylalgia (LE)) is the most common musculoskeletal condition of the elbow and affects up to 40% of the population at some stage in their lives. Recurrence and chronicity is common with over 50% of patients attending general practice reporting ongoing symptoms after 12months. The current paper outlines the current best evidence for diagnosis, assessment and treatment for LE by physiotherapists.
Diagnosis is based on clinical history and physical examination, with imaging only indicated for differential diagnosis. Assessment should include pain free grip strength testing and the PRTEE questionnaire. Treatment should include advice, education, exercise and Mulligans MWM’s in the first instance.
For those either with a score of greater than 54/100 on the PRTEE or have no improvement after 3months of treatment then imaging should be considered for differential diagnosis. Consideration should be given to the possibility of central sensitisation as well as referral to a pain management specialist for multimodal rehabilitation.
Please note injection therapy has not been included in this review, however a recent systematic review by Dong et al (2015) concluded that cortisone is NOT an effective treatment option.
> From: Bisset et al., J Physiother 61 (2015-12-14 06:44:26) 174-181 . All rights reserved to Australian Physiotherapy Association. Click here for the online summary. Translation by Andrew Clark