Abstract
BackgroundThe treatment of first choice for lateral epicondylalgia humeri is conservative therapy. Recent findings indicate that spinal manual therapy is effective in the treatment of lateral epicondylalgia. We hypothesized that thoracic spinal mobilization in patients with epicondylalgia would have a positive short–term effect on pain and sympathetic activity.MethodsThirty patients (all analyzed) with clinically diagnosed (physical examination) lateral epicondylalgia were enrolled in this randomized, sample size planned, placebo-controlled, patient-blinded, monocentric trial. Pain-free grip, skin conductance and peripheral skin temperature were measured before and after the intervention. The treatment group (15 patients) received a one-time 2-min T5 costovertebral mobilization (2 Hz), and the placebo group (15 patients) received a 2-min one-time sham ultrasound therapy.ResultsMobilization at the thoracic spine resulted in significantly increased strength of pain-free grip + 4.6 kg ± 6.10 (p = 0.008) and skin conductance + 0.76 μS ± 0.73 (p = 0.000004) as well as a decrease in peripheral skin temperature by − 0.80 °C ± 0.35 (p < 0.0000001) within the treatment group.ConclusionA thoracic costovertebral T5 mobilization at a frequency of 2 Hz shows an immediate positive effect on pain-free grip and sympathetic activity in patients with lateral epicondylalgia.Clinical trial registrationGerman clinical trial register DRKS00013964, retrospectively registered on 2.2.2018.
Highlights
The treatment of first choice for lateral epicondylalgia humeri is conservative therapy
This study investigates the short-term effects of thoracic mobilization on painfree grip (PFG) and sympathetic nervous system (SNS) activity in patients with lateral epicondylalgia
Thoracic costovertebral T5 mobilization at a frequency of 2 Hz has immediate unilateral positive effects recorded as an increase in pain-free grip and sympathetic activity in patients with lateral epicondylalgia
Summary
The treatment of first choice for lateral epicondylalgia humeri is conservative therapy. Colloquially called tennis elbow, is a common musculoskeletal disorder within the working population between 35 and 55 years of age [1,2,3]. It affects 40% of the population once in a lifetime [4] at a prevalence of 1–3% [1]. This pathology involves the tendons that connect the forearm extensors to the lateral epicondyle of the humerus [2]. Extension of the second and third fingers, as well as gripping cause pain [6,7,8]
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