Authors (including presenting author) :
Leung YHJ(1), Sze KTA(1), SUEN MYAB(1), MAK MYM(2), CHAN LCJ(3)
Affiliation :
(1) Department of Physiotherapy, Tin Shui Wai Hospital, (2) Department of Physiotherapy, Tuen Mun Hospital, (3) Department of Physiotherapy, Pok Oi Hospital
Introduction :
Lateral epicondylitis, commonly known as tennis elbow, is a musculoskeletal pain condition manifested with pain at the common extensor tendon (CET) on lateral epicondyle during palpation and active fist clenching. There is ample evidence that acupuncture is an effective treatment for pain relief of lateral epicondylitis. However, the effect on micro-structural changes is uncertain. Point-of-care ultrasound could evaluate the effect of acupuncture on CET thickness and ultrasonographic feature of the tendon, such as presence of tendinosis or calcification, in patients with lateral epicondylitis.
Objectives :
The aim of this case series was to evaluate the clinical and ultrasonographic effect of acupuncture in patients with lateral epicondylitis.
Methodology :
Patients whose diagnosis was lateral epicondylitis were recruited with convenient sampling in Tin Shui Wai Hospital Physiotherapy Out-patient department from Jan 2019 to Nov 2019. These patients received a total of 8 sessions of weekly acupuncture treatment in addition to conventional physiotherapy treatment. The outcome measures were pain score on Numeric Pain Rating Scale (NPRS), ultrasonographic feature of common extensor tendon, abbreviated version of Disabilities of the Arm, Shoulder and Hand questionnaire (qDASH), hand grip strength, CET thickness and Numeric Global Rate of Change Scale (NGRCS). Measurements were taken at the 1st and 8th session of the acupuncture treatment program.
Result & Outcome :
Eight elbows from 8 patients completed the 8-session acupuncture treatment program. Wilcoxon signed rank test was used for comparison of the outcome measures except NGRCS.
There were significant improvements in ultrasonographic feature (p=0.014) and NPRS (p=0.024). These suggested that the CET changed from tendinosis to normal on ultrasound imaging and pain score decreased after 8 sessions of acupuncture treatment program. However, there was only a trend in reduction in qDASH (p=0.351), hand grip strength (p=0.231) and CET thickness (p=0.674). The mean NGRCS was 60% (SD: 26.2%). This could be due to small sample size of the study.
These findings showed that the ultrasonographic feature and pain score were improved in patients with lateral epicondylitis after 8 sessions of acupuncture treatment program and could provide extra clinical information on patient education and empowerment.
