Clinical Trial Details
— Status: Recruiting
Administrative data
NCT number |
NCT05504759 |
Other study ID # |
2166 |
Secondary ID |
|
Status |
Recruiting |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
February 2, 2021 |
Est. completion date |
August 2, 2023 |
Study information
Verified date |
August 2022 |
Source |
Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey |
Contact |
Ömer Faruk Ünelli, MD |
Phone |
05069195869 |
Email |
funelli[@]hotmail.com |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
In this study, investigators aimed to investigate the effects of rest, steroid injection and
dry needling treatments, which are frequently used in the treatment of patients diagnosed
with lateral epicondylitis (tennis elbow), on the pain and functional status of the patients.
Description:
Lateral epicondylitis is one of the most common painful conditions of the arm, characterized
by pain in the lateral epicondyle where the wrist extensors muscles originate and on the
extensor muscle surface of the forearm, and is also called tennis elbow. The incidence of
lateral epicondylitis has been reported as 1-3%. The age of onset is between 35 and 50, and
it is more common in men. Mostly the dominant arm is affected, rarely bilateral. It may occur
as a result of repetitive and difficult wrist extension. Tenderness in the lateral
epicondyle, pain that can be revealed with resistant wrist extension and middle finger
extension, decrease in grip strength and significant limitation in daily living activities
are the main findings. The repetition of the movement is more important than the force
required to perform the movement in the development of the symptoms. Extensor muscles are
under extreme stress in those who work in jobs that require continuous rotation of the wrist,
such as grasping, supination, and pronation, or in these types of sports. As a result of
forcing, soft tissues such as muscles, ligaments and tendons in the forearm cannot meet the
load they are exposed to, and thus symptoms occur. Although it originates from the muscle
extensor carpi radialis brevis (ECRB), where pathological changes are primarily seen; It can
also be seen at the origin of the extensor carpi radialis longus (ECRL) and extensor
digitorum communis (EDK) muscles. Myofascial trigger points formed in the forearm extensor
group muscles are frequently detected during examination.
The basic principles of treatment in lateral epicondylitis are to relieve pain, accelerate
the healing process, reduce overloads on the arm, and enable the patient to return to daily
life activities. Conservative treatment options are rest, splint, ice application,
electrotherapy, massage, manipulation, mobilization, exercise and medical therapy.
When investigators examine the literature, although there are many studies on conservative
methods and steroid injection in the treatment of lateral epicondylitis; investigatorsfound
several studies on the effectiveness of dry needling in lateral epicondylitis. In the current
study, the efficacy of dry needling was compared with the conservative method, which is only
the first-line treatment. In addition, in these studies, dry needling was applied to the
musculeutendinous junction. Investigators observed that lateral epicondylitis is a disease
that is activated by tendinopathy and can cause multiple painful tender points and tight
bands in the forearm muscles. In this context, investigators think that more studies are
needed on the effectiveness of dry needling in lateral epicondylitis. In this study,
investigators aimed to investigate the effects of rest, steroid injection and dry needling
treatments, which are frequently used in the treatment of patients diagnosed with lateral
epicondylitis (tennis elbow), on the pain and functional status of the patients.
The first stage of treatment is rest, orthoses can also be used in this regard. The use of a
forearm support band and a splint to keep the wrist at 20 degrees of extension also helps to
keep the extensor muscles in a relaxed position, resting these muscles.
At the end of the 2-week rest period, patients are given strengthening and stretching
exercises. Strengthening the wrist extensors increases the tolerance of the damaged
attachment to repetitive and resistant movement. Mills maneuver, that is, extension of the
elbow, pronation of the forearm, flexion of the wrist and ulnar deviation as a stretching
exercise for 30-45 seconds. applicable. The goal with stretching is to lengthen the scar
tissue.
Ultrasound, iontophoresis, laser, interference currents, electrical stimulation, ESWT are
physical therapy methods used in lateral epicondylitis. In addition to the analgesic effects
of these treatment methods, their contribution to the healing process of the damaged tissue
has also been reported.In addition, various injection methods (steroid injection,
prolotherapy, platelet rich plasma (PRP), dry needling) are also used in the routine
treatment of lateral epicondylitis.
Many treatment methods have been reported in the studies on the treatment of lateral
epicondylitis, but in general, insufficient number of patients and short follow-up periods
are stated as the missing aspects of the studies. The aim of our study is to evaluate in
detail the methods used in the routine for treatment, which do not have side effects and are
comfortable, and compare the superiority of the methods to each other. In addition, by
examining the efficacy of treatment with sufficient number of patients and follow-up period
in our study; It is aimed to contribute to the literature by evaluating the methods in terms
of safety, effectiveness, efficiency, accessibility, quality and determining the most
appropriate methods for clinical practice.