Abstract
Objectives: Lateral epicondylitis (tennis elbow) is a tendinosis of the forearm extensor muscles; it has a clear occupational profile. Epicondylitis usually improves with conservative treatment but some 10% of cases require more invasive therapies, such as shock waves, infiltration with steroids or growth factors. Although its mechanism of action is unknown, pulsed radiofrequency appears to improve the patient’s perception of pain. In recent years, this has been used in peripheral pathologies with promising results. This study evaluates the efficacy of two different patterns of radiofrequency for treating epicondylitis. Materials and methods: This was a comparative study of 34 patients, divided randomly intotwo groups: Group A received pulsed radiofrequency (PRF) at the lateral epicondyle trigger point with two needles (45 volts, for four minutes), creating a dual field; whenever a trigger point was located at the exit of the posterior interosseous, PRF was applied for two minutes; Group B received PRF at the lateral cutaneous branch of the radial nerve for 4 minutes; whenever a trigger point was located at the exit of the posterior interosseous, PRF was applied for two minutes. All patients were monitored during a six-month follow-up. Results: In general, there was a tendency for pain to decrease, but the visual analogical scale(VAS) identified significantly higher decreases in Group B than Group A. Group Atreatment was effective (VAS decreased more than 50%) for 23% of patients after one month, for 47% of patients after three months and 58.8% of patients after six months. Group B results were better, with decreases in pain experienced by 65% of patients after one month, and 82.3% of patients after three and six months. The recovery of strength was also greater in Group B (8 out of 10) than Group A (6 out of 12). The average time passed before Group A patients could return to work following treatment was 3.058 ± 2.4, and 1.176 ± 1.24 months for Group B patients. Conclusions: When epicondylitis fails to respond to conservative treatment, pulsedradiofrequency is a safe, partially effective technique. Its effect is greater when it is applied to peripheral nerves than to trigger points.
Highlights
Public health is commonly deined as ‘the science and art of preventing disease, prolonging life and promoting health through the organised eforts of society’ [1]
Selective research studies of the prevalence of Complementary and Alternative Medicine (CAM) are used, drawing in particular on the most recent systematic review [14]. he review was undertaken by members of the European research network for complementary and alternative medicine, CAM brella, established under the European Union’s Seventh Framework Programme. he group comprised 16 partner institutions from 12 European countries and focused on academic research into, but not the advocacy for, any CAM treatment. he third source uses two research studies which the author either led or was a co-investigator; these are used as case studies to demonstrate the innovative potential of CAM
CAM comprises a diverse set of modalities and multiple healing systems
Summary
Public health is commonly deined as ‘the science and art of preventing disease, prolonging life and promoting health through the organised eforts of society’ [1] It centres on promoting and protecting the health of communities, individual citizens and the wider population. His policy framework aims to ‘signiicantly improve the health and well-being of populations, reduce health inequalities, strengthen public health and ensure people-centred health systems.’ (ibid, p1). It identiies four priority areas for policy action, throughout emphasising ‘developing assets and resilience within communities, empowerment and creating supportive environments.’ (ibid, pvi). Important is health-related behaviour, including tobacco and alcohol use, diet and physical activity: behaviour, which is itself socially determined and oten relects the stresses and disadvantages in people’s lives.’ he challenge of converting this political/policy level rhetoric into implementation and practical action remains to be realised
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