Abstract
M.Tech.
Purpose: Lateral epicondylitis has been identified as one of the most common conditions
affecting the upper limb. The exact pathophysiology of this condition is still under investigation;
however it is believed to be an overuse injury which affects the common extensor tendon at
the tenoperiosteal and/or the musculotendonous junctions. Despite the frequent occurrence of
lateral epicondylitis and its considerable symptoms there is little scientific evidence to support
the effectiveness of any treatment methods. As yet one treatment method has not been
proved more effective than the other. The purpose of this comparative study was to determine
whether manipulation combined with dry needling of the common extensor tendon and
extensor muscle belly of the forearm, was more effective than cross friction of the common
extensor tendon combined with manipulation with regards to a decrease in pain and an
increase in pressure pain threshold.
Method: This study consisted of 32 participants between the ages of 18 – 40. Possible
participants were examined and accepted according to the inclusion and exclusion criteria.
Once accepted the participants were assigned into two groups each consisting of equal
amounts of males and females. The first group received manipulation of their elbow combined
with dry needling of their common extensor tendon and extensor muscle belly of their forearm.
The second group also received manipulation of their elbow but this was combined with cross
friction of their common extensor tendon.
Procedure: Each participant received six treatment sessions and one follow up session.
Objective data and subjective data was taken at the beginning of the first, fourth and seventh
session. Objective data consisted of algometer readings that were taken on the common
extensor tendon, the lateral epicondyle of the humerus and the extensor muscle belly. The
subjective data collected was in the form of the Numerical Pain Rating Scale and the short
form of the McGill Pain Questionnaire. The manipulation of the elbow was then administered
based on the restrictions identified during motion palpation. This was followed by either dry
needling of the common extensor tendon and the extensor muscle belly of the forearm or cross
v
friction of the common extensor tendon. The information collected was analysed by means of
Friedman and Wilcoxon Signed Rank tests.Results: Statistically significant improvements in all measurements were noted over the
course of the treatments for all participants in both groups. However there was no statistically
significant difference between the improvements of the dry needling group compared to that of
the cross friction group.
Conclusion: The results illustrate the effectiveness of the individual treatments over the
treatment period. However it is still inconclusive whether one treatment method is more
effective than the other. As this study was directed to a small group of participants, accurate
conclusions could not be formulated to prove the effectiveness of one treatment method over
that of another. Due to the insignificant findings obtained in this study, further studies need to
be performed to determine which method of treatment is most effective when treating lateral
epicondylitis.