Treatment Modalities for Tennis Elbow


Objective: To evaluate the available evidences of the effectiveness of physiotherapy for Tennis Elbow by several physical methods in comparing to results and effects of local steroid injections to the affected elbows as the first choice treatment before using alternative means. Method: Selected cases identified by a search strategy in one database of two independent groups of totally 63 patients who confirmed to be had tennis elbow according to a report of Delphi consensus workshop at university of Birmingham in 1997, and these patients are totally regarded as the backbone for fulfillment of this study in a totally 7567 patients attended to the rheumatology and medical rehabilitation department at Rizgari teaching hospital in Hawler province during the second half of 2006 . At least one clinically relevant outcome measure is regarded as a reviewer in a selected group of patients who submit physical therapy methods in comparing versus to local injection treatment in another group. Methodological quality was independently assessed by the results review. A best evidence synthesis, including a quantitative and qualitative analysis, was conducted, weighing the studies with respect to their statistical significance, clinical relevance, and statistical power. Results: Among selected patients with tennis elbow who included in this study, evaluating the effects of physical therapy by electrotherapy, ultrasound and deep friction massage in 48 patients (67%) of group (A) are done in compare to 15 patients (24%) in the another group ( B) whom treated by local corticosteroid injections. Despite irrelevant data and insufficient studies, the clinical and statistical results were regard to be significant and making relevant differences in favor of physical therapies. There is quiet evidence demonstrate benefit of effect of physical therapy methods by 48% for long term period (more than three months ) as an effective strategy , in comparing treatment by local steroid injection in short term (less than 6 weeks) duration which regarded as the swift choice for relief or diminish the pain for the affected elbow in the rate of 20 to 66% respectively.Conclusion: Physical therapies are regard to be the solely preferable choice versus to local steroid injection in a long term management for tennis elbow patients. Key words: Tennis Elbow (TE), Treatment Modalities