title: Comparison of two methods for the evaluation of treatment in medial epicondylitis: pain estimation vs grip strength measurements.
abstract: BACKGROUND
  Determination of a precise and reproducible diagnostic tool for the evaluation of patients with medial epicondylitis (ME) is important for an effective follow-up. The commonly suggested use of grip strength measurements with a hand dynamometer is not always easily available and may be affected by the patient's compliance. We propose that pain estimation based on the visual analog scale can be considered for this purpose as well because it addresses the painful degenerative lesion in the common flexor origin, which is the basic pathological process in ME.
  
  
  METHODS
  We analyzed and compared 237 different sets of measurements of grip strengths and pain evaluation, according to the visual analog scale, in 79 patients with ME. For the purpose of this comparison, we developed a qualitative grading system based on the statistical data of the grip strength values in the normal population.
  
  
  RESULTS
  High dependency between the graded pain evaluation and measured grip strength was found.
  
  
  CONCLUSIONS
  We suggest that evaluation of patients with ME according to the proposed grading method of pain evaluation is as accurate as grip strength measurements.
authors.affiliation: Orthopaedics A Department, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, PO Box 9602, 31096 Haifa, Israel. nahumrosenberg@hotmail.com
authors.forename: Nahum
authors.initials: N
authors.lastname: Rosenberg
authors.forename: Michael
authors.initials: M
authors.lastname: Soudry
authors.forename: Shalom
authors.initials: S
authors.lastname: Stahl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D010808:Physical Examination / Q000379:methods*; D026741:Physical Therapy Modalities / Q000379:methods; D011336:Probability; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013716:Tennis Elbow / Q000175:diagnosis* / Q000188:drug therapy / Q000534:rehabilitation
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal