Evidence based data for management of lateral epicondylitis: Review

Abstract

The aim of this review is to identify the evidence base data about a wide variety of treatment modalities used in lateral epicondylitis (LE). For optimal treatment choice the evidence based scientific data have to be used. Also the strong and weak evidences are important for planning further clinical research. Cochrane library is regularly updated collection of evidence base medical database. In this review the Cochrane Library database was searched using lateral epicondylitis/ tennis elbow key words. This search yielded eight Cochrane reviews [Cochrane Database of Systematic Reviews (CDSR, Cochrane Reviews)]: Non-steroidal anti-inflammatory drugs (NSAIDs) 2001, corticosteroid injections (protocol) 1999, orthotic devices 2002, deep transverse friction massage 2002, shock wave therapy (ESWT) 2005, acupuncture 2002, physiotherapy and physiotherapeutical modalities (protocol) 1999, surgery 2002. In addution, 18 non-Cochrane reviews [Cochrane Database of Abstracts of Reviews of Effects (DARE)] were included. Treatment modalities not mentioned in these reviews were also briefly mentioned. Many of these reviews concluded that there was insufficient evidence to support any treatment over another, predominantly because of the low statistical power, inadequate internal validity and insufficient data, heterogeneity in control groups, type of outcome measures, duration of the complaints and presence of prognostic factors and low number of patients in the studies. Despite the high prevalence of LE and the substantial loss of work associated with this condition, there is little consensus on its management. Well designed, high quality randomized controlled studies are needed to draw conclusions about the optimal treatment of LE. © 2010 by Türkiye Klinikleri.