Abstract
Lateral epicondylalgia (LE), a common overuse syndrome of the extensor muscle and tendons on the lateral epicondyle, causes persistent severe musculoskeletal pain on the outer part of the elbow. Fu's subcutaneous needling (FSN), a newly invented subtype of acupuncture and dry needling, is a new trend and potential treatment of LE by targeting the myofascial trigger points (MTrPs). However, no scientific evidence is available to support this method. This study aims to evaluate the distal FSN treatment on the LE by measuring pain-related scales, such as visual analog scale (VAS), pressure pain threshold (PPT), muscle tissue hardness (TH), pain-free grip (PFG), and the functional outcome by a patient-rated tennis elbow evaluation (PRTEE) questionnaire study. A total of 60 LE patients were randomly divided into FSN (n = 30) and transcutaneous electrical nerve stimulation (TENS, n = 30) as the control group. Every subject was treated with three regimens and followed up for 15 days. Results showed that FSN has an immediate effect on VAS, PPT, TH, and PFG. Moreover, sustained effects on pain relief were followed up to 15 days. Pain remission was consistent with long-term PRTEE results. Overall, FSN is a safe and efficient therapy option for LE, significantly improving pain relief and activity difficulty with immediate, short-term, and long-term effectiveness. This trial is registered with ClinicalTrials.gov NCT03605563.
Highlights
Lateral epicondylalgia (LE), known as tennis elbow, is one of the musculoskeletal disorders and is the most common cause of elbow pain due to overuse of the extensor muscle and tendons [1]. e prevalence of LE is approximately 1% to 3% of the overall population; LE is found in up to 23% of male tennis athletes [2, 3]. e pain and tenderness caused by LE are highly related to repeated and forceful contractions of the wrist and fingers muscles, which is commonly seen in griping and holding continuously for a long time [4]
visual analog scale (VAS) and pain-free grip (PFG) were significantly improved in the transcutaneous electrical nerve stimulation (TENS) group (Figures 4(a) and 4(d)). ese results indicated that Fu’s subcutaneous needling (FSN) had an instant pain relief effect for LE with a decrease in VAS and tissue hardness (TH) and an increase in pressure pain threshold (PPT) and PFG compared with TENS
Data were expressed as mean ± SD; P value was analyzed by the t-test
Summary
Lateral epicondylalgia (LE), known as tennis elbow, is one of the musculoskeletal disorders and is the most common cause of elbow pain due to overuse of the extensor muscle and tendons [1]. e prevalence of LE is approximately 1% to 3% of the overall population; LE is found in up to 23% of male tennis athletes [2, 3]. e pain and tenderness caused by LE are highly related to repeated and forceful contractions of the wrist and fingers muscles, which is commonly seen in griping and holding continuously for a long time [4]. Lateral epicondylalgia (LE), known as tennis elbow, is one of the musculoskeletal disorders and is the most common cause of elbow pain due to overuse of the extensor muscle and tendons [1]. Conventional treatments, including local injections with anesthetics [8], steroids [9], and platelet-rich plasma [10], extracorporeal shock waves [11], transcutaneous electrical nerve stimulation (TENS) [12], acupuncture [13, 14], and dry needling [15, 16] are widely used. Most of these treatments only provide short-term pain relief. FSN has an immediate and long-lasting effect on pain control of musculoskeletal diseases through the swaying and reperfusion approach [17, 18]. The scientific evaluation of FSN on short- and long-term effectiveness is still lacking
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