Lateral epicondylalgia: an overview

Abstract

Lateral epicondylalgia is a complex condition affecting both athletes and sedentary people. Many patients do not respond to physiotherapy and the condition has a high recurrence rate. Lateral epicondylalgia may be more complex than a simple lesion at the common extensor tendon. Clinical trials in this area have failed to find conclusive evidence to support the conservative treatment of lateral epicondylalgia. Common confounding variables in such clinical trials include wide ranges of duration of symptoms within a sample, and subjects with different modes of onset. In some trials, the co-existence of cervical spine dysfunction and altered neurodynamics is noted, but not treated; this may represent a reason for the poor results reported from clinical trials. It has been suggested that lateral epicondylalgia is a multistructural pathology, but this is not quantified or controlled for in any of the clinical trials; this also has implications for therapy. If lateral epicondylalgia is a multistructural pathology, then it is essential to have a standard method of assessing and quantifying the extent to which other structures are involved. This would allow for better standardisation of the samples included in clinical trials, which would then potentially lead to a better understanding of appropriate therapy.

Keywords:

• ELBOW
• LATERAL EPICONDYLITIS
• TENNIS ELBOW