title: Pulsed low-intensity ultrasound therapy for chronic lateral epicondylitis: a randomized controlled trial.
abstract: OBJECTIVE
  Pulsed low-intensity ultrasound therapy (LIUS) has been found to be beneficial in accelerating fracture healing and has produced positive results in animal tendon repair. In the light of this we undertook a randomized, double-blind, placebo controlled trial to assess the effectiveness of LIUS vs placebo therapy daily for 12 weeks in patients with chronic lateral epicondylitis (LE).
  
  
  METHODS
  Patients with LE of at least 6 weeks' duration were recruited from general practice, physiotherapy and rheumatology clinics, and had to have failed at least one first-line treatment including non steroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injection. Participants were assigned either active LIUS or placebo. Treatment was self-administered daily for 20 min over a 12-week period. The primary end-point was a 50% improvement from baseline in elbow pain measured at 12 weeks using a patient-completed visual analogue scale.
  
  
  RESULTS
  Fifty-five subjects aged 18-80 were recruited over a 9-month period. In the active group 64% (16/25) achieved at least 50% improvement from baseline in elbow pain at 12 weeks compared with 57% (13/23) in the placebo group (difference of 7%; 95% confidence interval -20 to 35%). However, this was not statistically significant (chi(2) = 0.28, P = 0.60).
  
  
  CONCLUSIONS
  In this study LIUS was no more effective for a large treatment effect than placebo for recalcitrant LE. This is in keeping with other interventional studies for the condition.
authors.affiliation: Rheumatology Research Unit, Addenbrooke's Hospital, Cambridge University NHS Trust, Cambridge, UK.
authors.forename: A P
authors.initials: AP
authors.lastname: D'Vaz
authors.forename: A J K
authors.initials: AJ
authors.lastname: Ostor
authors.forename: C A
authors.initials: CA
authors.lastname: Speed
authors.forename: J R
authors.initials: JR
authors.lastname: Jenner
authors.forename: M
authors.initials: M
authors.lastname: Bradley
authors.forename: A T
authors.initials: AT
authors.lastname: Prevost
authors.forename: B L
authors.initials: BL
authors.lastname: Hazleman
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D012648:Self Care; D013716:Tennis Elbow / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*