title: Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia.
abstract: The treatment of lateral epicondylalgia, a widely-used model of musculoskeletal pain in the evaluation of many physical therapy treatments, remains somewhat of an enigma. The protagonists of a new treatment technique for lateral epicondylalgia report that it produces substantial and rapid pain relief, despite a lack of experimental evidence. A randomized, double blind, placebo-controlled repeated-measures study evaluated the initial effect of this new treatment in 24 patients with unilateral, chronic lateral epicondylalgia. Pain-free grip strength was assessed as an outcome measure before, during and after the application of the treatment, placebo and control conditions. Pressure-pain thresholds were also measured before and after the application of treatment, placebo and control conditions. The results demonstrated a significant and substantial increase in pain-free grip strength of 58% (of the order of 60 N) during treatment but not during placebo and control. In contrast, the 10% change in pressure-pain threshold after treatment, although significantly greater than placebo and control, was substantially smaller than the change demonstrated for pain-free grip strength. This effect was only present in the affected limb. The selective and specific effect of this treatment technique provides a valuable insight into the physical modulation of musculoskeletal pain and requires further investigation.
authors.affiliation: The University of Queensland, St Lucia, Australia. b.vincenzino@shrs.uq.edu.au
authors.forename: B
authors.initials: B
authors.lastname: Vicenzino
authors.forename: A
authors.initials: A
authors.lastname: Paungmali
authors.forename: S
authors.initials: S
authors.lastname: Buratowski
authors.forename: A
authors.initials: A
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular; D013716:Tennis Elbow / Q000503:physiopathology / Q000628:therapy*