Tennis elbow, also known as lateral epicondylitis, is a common condition characterised by pain and inflammation on the outer side of the elbow, typically resulting from repetitive strain or overuse of the forearm extensor muscles. Treatment for tennis elbow often involves a multimodal approach, including manual therapy. Here's an overview of the evidence regarding manual therapy in treating tennis elbow:
Manual Therapy Techniques: Manual therapy techniques commonly used in the treatment of tennis elbow include soft tissue mobilisation, joint mobilisation, myofascial release, and manipulation. These techniques aim to reduce pain, improve tissue flexibility, and promote healing by addressing soft tissue restrictions, joint stiffness, and muscle tightness around the affected area.
Effectiveness of Manual Therapy: Several systematic reviews and meta-analyses have evaluated the effectiveness of manual therapy in treating tennis elbow. While the evidence is mixed, some studies have reported positive outcomes with manual therapy interventions, including improvements in pain, function, grip strength, and patient satisfaction.
Comparison to Other Treatments: Manual therapy interventions are often compared to other conservative treatments for tennis elbow, such as exercise therapy, corticosteroid injections, nonsteroidal anti-inflammatory drugs (NSAIDs), and brace or splinting. Some studies have suggested that manual therapy may be as effective as or more effective than other conservative treatments in reducing pain and improving function in patients with tennis elbow.
Combined Treatment Approaches: Manual therapy is frequently used as part of a comprehensive treatment approach for tennis elbow, which may also include exercises to strengthen and stretch the forearm muscles, activity modification, ergonomic interventions, and adjunctive modalities such as ultrasound or extracorporeal shockwave therapy (ESWT).
Individualised Treatment: The effectiveness of manual therapy in treating tennis elbow may vary depending on factors such as the severity and chronicity of the condition, individual patient characteristics, the presence of underlying pathology, and the skill and experience of the therapist performing the manual therapy techniques. A comprehensive assessment and individualised treatment plan tailored to the patient's specific needs are essential for optimising outcomes.
Need for Further Research: Despite the existing evidence supporting the use of manual therapy in treating tennis elbow, there is still a need for further high-quality research, including randomized controlled trials with long-term follow-up, to better understand the role of manual therapy interventions and their comparative effectiveness in managing tennis elbow.
In summary, manual therapy techniques are commonly used as part of multimodal treatment approaches for tennis elbow, and while there is evidence supporting their effectiveness, further research is needed to elucidate their role and comparative effectiveness in managing this condition.