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The effects of elbow manipulation combined with dry needling compared to manipulation combined with cross friction in the treatment of lateral epicondylits

M.Tech. / Purpose: Lateral epicondylitis has been identified as one of the most common conditions affecting the upper limb. The exact pathophysiology of this condition is still under investigation; however it is believed to be an overuse injury which affects the common extensor tendon at the tenoperiosteal and/or the musculotendonous junctions. Despite the frequent occurrence of lateral epicondylitis and its considerable symptoms there is little scientific evidence to support the effectiveness of any treatment methods. As yet one treatment method has not been proved more effective than the other. The purpose of this comparative study was to determine whether manipulation combined with dry needling of the common extensor tendon and extensor muscle belly of the forearm, was more effective than cross friction of the common extensor tendon combined with manipulation with regards to a decrease in pain and an increase in pressure pain threshold. Method: This study consisted of 32 participants between the ages of 18 – 40. Possible participants were examined and accepted according to the inclusion and exclusion criteria. Once accepted the participants were assigned into two groups each consisting of equal amounts of males and females. The first group received manipulation of their elbow combined with dry needling of their common extensor tendon and extensor muscle belly of their forearm. The second group also received manipulation of their elbow but this was combined with cross friction of their common extensor tendon. Procedure: Each participant received six treatment sessions and one follow up session. Objective data and subjective data was taken at the beginning of the first, fourth and seventh session. Objective data consisted of algometer readings that were taken on the common extensor tendon, the lateral epicondyle of the humerus and the extensor muscle belly. The subjective data collected was in the form of the Numerical Pain Rating Scale and the short form of the McGill Pain Questionnaire. The manipulation of the elbow was then administered based on the restrictions identified during motion palpation. This was followed by either dry needling of the common extensor tendon and the extensor muscle belly of the forearm or cross v friction of the common extensor tendon. The information collected was analysed by means of Friedman and Wilcoxon Signed Rank tests.Results: Statistically significant improvements in all measurements were noted over the course of the treatments for all participants in both groups. However there was no statistically significant difference between the improvements of the dry needling group compared to that of the cross friction group. Conclusion: The results illustrate the effectiveness of the individual treatments over the treatment period. However it is still inconclusive whether one treatment method is more effective than the other. As this study was directed to a small group of participants, accurate conclusions could not be formulated to prove the effectiveness of one treatment method over that of another. Due to the insignificant findings obtained in this study, further studies need to be performed to determine which method of treatment is most effective when treating lateral epicondylitis.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uj/uj:7136
Date29 June 2011
CreatorsHughes, Nicholla Maray
Source SetsSouth African National ETD Portal
Detected LanguageEnglish
TypeThesis

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