Abstract
The purpose of this study was to explore the effectiveness of chiropractic manipulative therapy on the wrist, in treating lateral epicondylitis. It also aimed to determine the effectiveness of Mills’ manipulation applied to elbow, and whether adjusting both the elbow and the wrist would be more effective than simply adjusting the elbow or the wrist in isolation.
Thirty patients suffering from lateral epicondylitis who conformed to specific diagnostic criteria were accepted for the trial. The patients were stratified according to age and sex and placed into three groups of ten. The first group received chiropractic manipulative therapy directed to the wrist. The second group received chiropractic manipulative therapy directed to the elbow complex, and the third group received chiropractic manipulative therapy directed at both areas. The treatment consisted of four sessions over a period of 2 weeks.
The groups were assessed and compared in terms of objective and subjective measurements to determine the most beneficial treatment. The data was collected at the beginning of each treatment session. Subjective data consisted of the Numerical Pain Rating Scale 101 (Vernon in Liebenson, 1996:61) and the short form Mc Gill Pain Questionnaire (Melzack, 1987:192), which assessed patients’ discomfort levels. Objective data was collected by means of the Jamar Grip Strength Dynamometer (Kaufman, 2000:619) and the Pressure Algometer (Fischer, 1987:213), which measured the grip strength and pressure pain threshold respectively.
The results showed that both wrist and Mills’ manipulation in isolation as well as in combination are beneficial in treating lateral epicondylitis, in that they all showed subjective and objective improvements. The Mills’ manipulation alone and in combination with wrist manipulations had superior clinical effects compared to the wrist manipulations in isolation. The statistical results of the inter-group analysis revealed that there was no significant difference between the outcomes of the wrist manipulation, Mills’ manipulation and combined treatment protocols and therefore none are expressly recommended above the other.
Dr. C. Yelverton
Dr. C. Lyons