Acupuncture for Lateral Epicondylitis: A Systematic Review.

Hongzhi Tang,Huaying Fan,Fanrong Liang,Xuebing Yi,Junrong Chen,Liugang Tang,Jiao Chen,Haibo Rong,Guogang Dai,Junhua Wu,Mingxiao Yang

doi:10.1155/2015/861849

Abstract

Objective. This systematic review aimed to assess the effectiveness and safety of acupuncture for lateral epicondylitis (LE). Methods. Seven databases and the WHO International Clinical Trials Registry Platform Search Portal were searched to identify relevant studies. The data were extracted and assessed by two independent authors, and Review Manager Software (V.5.3) was used for data synthesis with effect estimate presented as standard mean difference (SMD) and mean difference (MD) with a 95% confidence interval. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the level of evidence. Results. Four RCTs with 309 participants were included with poor methodological quality. Participants who received acupuncture and acupuncture plus moxibustion with material insulation were likely to have an improvement in elbow functional status and/or myodynamia. The overall quality rated by GRADE was from very low to low. Two studies reported that the needle pain would be the main reason for the dropout. Conclusion. For the small number of included studies with poor methodological quality, no firm conclusion can be drawn regarding the effect of acupuncture of elbow functional status and myodynamia for LE. This trial is registered with CRD42015016199.

Highlights

Lateral epicondylitis (LE), known as tennis elbow, is upper limbs associated musculoskeletal disorder and can be responsible for loss of function of the affected limb and substantial pain, which can have a major impact on patient’s social and professional life [1]
There were five systematic reviews that have been published during the last few years for assessing the effectiveness and safety of acupuncture for LE by evaluating the pain changes, but none of them draw a definitive conclusion on whether acupuncture is effective for LE or not
A total of 344 records and two registered trials were identified from the included databases. 75 duplicate records were excluded, among which 74 records were excluded by reading the title and abstract, and one record was excluded by reading the full article. 264 articles were excluded because they did not meet the inclusion criteria; one article was further excluded because the data of the study cannot be collected from the article and there was no response from the corresponding author

Summary

Introduction

Lateral epicondylitis (LE), known as tennis elbow, is upper limbs associated musculoskeletal disorder and can be responsible for loss of function of the affected limb and substantial pain, which can have a major impact on patient’s social and professional life [1]. Activities that involve excessive and repetitive use of the forearm extensor, such as typing, tennis, badminton, and manual work, may cause LE [4]. The principal cause of LE is the degeneration of the proximal wrist extensor tendons [5]. LE is a major problem that causes prolonged recovery of functional disability and long-time pain that impact patient’s daily life, and produces a heavy economic burden as lost workdays and, in some patients, inability to work may last for several weeks [6, 7]. While a number of treatment methods, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, exercise and mobilization, extracorporeal shock wave therapy, orthoses, and surgery, are used for LE, the lines of evidence of the effectiveness and safety of these therapy methods still remain uncertain [8,9,10,11,12,13]

Methods

Results

Conclusion