Dry needling in lateral epicondylitis: a prospective controlled study.

PURPOSE: Lateral epicondylitis (LE), a common disease, especially in middle age, causes decreased productivity and economic losses. The first-line treatment for LE is conservative and consists of topical and oral anti-inflammatory drugs, ice application, and brace use. If the first-line treatment fails, second-line treatment modalities, which are generally invasive, are offered. Second-line therapeutic regimens include saline, corticosteroid, or platelet-rich plasma injections. Dry needling is relatively new. We hypothesized that dry needling would be at least as effective as first-line treatment for LE. We compared the outcomes of first-line treatment and dry needling. METHODS: The study allocated 110 patients into groups using online randomization software. After completing the Patient-rated Tennis Elbow Evaluation (PRTEE), patients in group I received dry needling, whereas those in group II received first-line treatment, consisting of ibuprofen 100 mg twice a day and a proximal forearm brace. The patients were evaluated after three weeks and six months. RESULTS: The study ultimately analyzed 92 patients. Although both treatment methods were effective at three weeks, dry needling was significantly more effective than the first-line treatment at six months. CONCLUSION: Because of the low complication rate, dry needling is a safe method, and it might be an effective treatment option for LE.

Efectos de la estimulación interfibrilar contrairritante musculoesquelética en epicondilalgias de jugadores de pádel amateurs. Estudio piloto / Effects of the musculoskeletal interfibrillar counterirritattion stimulation technique on amateur paddle-tennis players’ epicondylalgia. Pilot study

Objetivo: Analizar la eficacia de la técnica de estimulación interfibrilar contrairritante musculoesquelética en jugadores de deportes de raqueta con epicondilalgia y puntos gatillo miofasciales (PGM) activos. Material y métodos: Se trata de un estudio piloto diseñado como ensayo clínico (prospectivo) aleatorizado a doble ciego. Se contó con jugadores de pala o raqueta que cumplían los siguientes criterios de inclusión: tener una edad comprendida entre 18 y 60 años (ambos incluidos), tener dolor en la zona del epicóndilo lateral y tener un PGM activo central en la musculatura epicondílea. La muestra fue de 68 sujetos, de los cuales 61 completaron el estudio; 30 del grupo intervención (aplicación de la técnica) y 31 del grupo control (aplicación de un vendaje simple). La variable principal fue la algometría (umbral de dolor a la presión sobre el PGM) y las secundarias fueron la escala analógica visual (EVA 0-10) y el Patient-Rated Tennis Elbow Evaluation. Resultados: Los valores de algometría y los valores de EVA muestran que hubo una disminución del dolor en ambos grupos, aunque sin diferencias estadísticamente significativas entre ellos. La comparación de los porcentajes iniciales y finales EVA≥4 tampoco muestra diferencias entre grupos, pero la comparación antes/después de ambos grupos es estadísticamente significativa (p<0,05). Conclusiones: La técnica de estimulación interfibrilar contrairritante musculoesquelética, aplicada en PGM centrales de la musculatura epicondílea en sujetos con epicondilalgia que practican deportes de raqueta/pala, no parece ser más efectiva que la aplicación de un vendaje simple sobre la zona

Objective: To analyse the effectiveness of the musculoskeletal interfibrillar counterirritattion stimulation technique (MICS) in racquet sports players with epicondylalgia and active myofascial trigger points (MTrPs). Material and methods: This is a pilot study designed as double-blind randomized clinical trial (prospective). It featured paddle or racquet sport players who met the following inclusion criteria: to be aged between 18 and 60 (inclusive), to have pain in the lateral epicondyle and to have a central active MTrP in the epicondylar musculature. The sample consisted of 68 subjects, of whom 61 completed the study; divided into 30 for the Intervention group (technique application) and 31 for the Control group (simple bandage). The primary variable was algometry (pain threshold to pressure on the MTrPs) and secondary variables were the VAS (visual analogue scale, 0-10) and the Patient-Rated Tennis Elbow Evaluation. Results: Algometry values and VAS values show that there was a decrease in pain in both groups, but no statistically significant differences between them. The comparison of the initial and final percentages VAS≥4 also do not show differences between groups, but improvement of both groups is statistically significant (P<.05). Conclusions: The musculoskeletal interfibrillar counterirritattion stimulation technique applied in the central MTrPs of epicondylar muscles in subjects with epicondylalgia who play racquet sports/paddle does not seem to be more effective than the application of a simple bandage over the area

Técnica de Thrust para la disfunción posterior de la cabeza del radio / Thrust technique for posterior disfunction of the radial head

Las disfunciones osteopáticas en el codo pueden causar absentismo laboral, con el gasto económico que ello conlleva para la sociedad, debido a la alta incidencia con la que estas disfunciones se presentan. Una de las lesiones osteopáticas que se pueden dar en el codo, es la disfunción de cabeza de radio posterior, que provoca un aumento del tono del músculo supinador corto, que a su vez puede referir dolor en la región externa del brazo y antebrazo. El objetivo de la técnica de thrust para la cabeza de radio posterior con contacto indexial, será anteriorizar la cabeza del radio, para así poder recuperar la funcionalidad en la articulación del codo. Para realizar correctamente la técnica, previamente habrá que llegar a un diagnóstico adecuado basado en la inspección, palpación, pruebas de movilidad, pruebas musculares, pruebas ortopédicas y radiología (AU)

Osteopathic dysfunctions in the elbow can cause work absenteeism, and the economic expense that this entails for society, due to the high incidence with which these dysfunctions occur. One of the osteopathic injuries that can occur in the elbow is posterior radial head dysfunction, which causes an increase in tone of the short supinator muscle, which in turn may refer pain in the external region of the arm and forearm. The objective of the thrust technique for the posterior radial head with indexial contact will be to forward the radial head in order to recover the functionality at the elbow joint. In order to correctly perform the technique, a proper diagnosis based on inspection, palpation, mobility tests, muscle tests, orthopedic tests and radiology must be previously arrived at (AU)