Effectiveness of diacutaneous fibrolysis for the treatment of chronic lateral epicondylalgia: a randomized clinical trial

Abstract

Objective: To assess the end of treatment and three months after treatment effects of diacutaneous fibrolysis as adjuvant of physical therapy for chronic lateral epicondylalgia. Design: Double-blind (patient and evaluator) randomized controlled trial. Setting: Primary Care Center of the Spanish NHS. Subjects: A total of 54 people with 60 elbows affected with chronic lateral epicondylalgia, 33 women, mean (SD) age was 48.43 (8.69) years. Interventions: All three groups (Intervention, Placebo and Control) received three weeks of physical therapy treatment and in addition Intervention Group received six sessions of real diacutaneous fibrolysis and Placebo Group received six sessions of sham diacutaneous fibrolysis. Main measures: Pain intensity, pressure pain threshold, pain free grip strength, function and subjective assessment were assessed at baseline, at the end of treatment and three months after treatment. Results: Between-group results at three months after treatment showed a statistically significant improvement of the Intervention Group in pain free grip strength (mean, 7.91 km/cm2; SD, 9.23) compared to the Placebo Group (mean, 1.47 km/cm2; SD, 7.86) and to the Control Group (mean, 2.09 km/cm2; SD, 4.45) (P values <0.01 and <0.03, respectively) and also in function (mean, 20.87; SD, 14.25) compared to the Control Group (mean, 4.17; SD, 18.02) (P < 0.01). Subjective assessment was statistically better in the Intervention Group both at the end of treatment (P < 0.01) and three months after treatment (P < 0.03). Conclusion: Diacutaneous fibrolysis added to physical therapy provides better results in the treatment of chronic lateral epicondylalgia, with greater clinical satisfaction among patients.