Elsevier

Manual Therapy

Volume 6, Issue 4, November 2001, Pages 205-212
Manual Therapy

Regular Article
Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia

https://doi.org/10.1054/math.2001.0411Get rights and content

Abstract

The treatment of lateral epicondylalgia, a widely-used model of musculoskeletal pain in the evaluation of many physical therapy treatments, remains somewhat of an enigma. The protagonists of a new treatment technique for lateral epicondylalgia report that it produces substantial and rapid pain relief, despite a lack of experimental evidence. A randomized, double blind, placebo-controlled repeated-measures study evaluated the initial effect of this new treatment in 24 patients with unilateral, chronic lateral epicondylalgia. Pain-free grip strength was assessed as an outcome measure before, during and after the application of the treatment, placebo and control conditions. Pressure-pain thresholds were also measured before and after the application of treatment, placebo and control conditions. The results demonstrated a significant and substantial increase in pain-free grip strength of 58% (of the order of 60 N) during treatment but not during placebo and control. In contrast, the 10% change in pressure-pain threshold after treatment, although significantly greater than placebo and control, was substantially smaller than the change demonstrated for pain-free grip strength. This effect was only present in the affected limb. The selective and specific effect of this treatment technique provides a valuable insight into the physical modulation of musculoskeletal pain and requires further investigation.

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    Bill Vicenzino, PhD, MSc, Grad Dip Sports Phty, B Phty, Senior lecturer, Aatit Paungmali MPhtyStudies (Orthopaedic Phty), BPhty (Hons), PhD candidate in Physiotherapy, Department of Physiotherapy, The University of Queensland, St Lucia, Australia. 4072, Sally Buratowski, BPhty (Hons), Private Practitioner, Nerang, Queensland, Australia,Anthony Wright, PhD, MPhty Studies (ManipPhty), BPhty (Hons) , Professor, Division of Physiotherapy, Curtin University of Technology, Australia, 6845.

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    Correspondence to: BV, Tel.: (61) 7 33652781; Fax: (61) 7 33652775; E-mail: [email protected]

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