Logo of brjsmedBritish Journal of Sports MedicineVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Br J Sports Med. 2005 Jul; 39(7): 411–422.
PMCID: PMC1725258

A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia

Full Text

The Full Text of this article is available as a PDF (149K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Allander E. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scand J Rheumatol. 1974;3(3):145–153. [PubMed]
  • Verhaar JA. Tennis elbow. Anatomical, epidemiological and therapeutic aspects. Int Orthop. 1994 Oct;18(5):263–267. [PubMed]
  • Kurppa K, Viikari-Juntura E, Kuosma E, Huuskonen M, Kivi P. Incidence of tenosynovitis or peritendinitis and epicondylitis in a meat-processing factory. Scand J Work Environ Health. 1991 Feb;17(1):32–37. [PubMed]
  • Ranney D, Wells R, Moore A. Upper limb musculoskeletal disorders in highly repetitive industries: precise anatomical physical findings. Ergonomics. 1995 Jul;38(7):1408–1423. [PubMed]
  • Kelley JD, Lombardo SJ, Pink M, Perry J, Giangarra CE. Electromyographic and cinematographic analysis of elbow function in tennis players with lateral epicondylitis. Am J Sports Med. 1994 May-Jun;22(3):359–363. [PubMed]
  • Gruchow HW, Pelletier D. An epidemiologic study of tennis elbow. Incidence, recurrence, and effectiveness of prevention strategies. Am J Sports Med. 1979 Jul-Aug;7(4):234–238. [PubMed]
  • Nirschl RP. Tennis elbow. Orthop Clin North Am. 1973 Jul;4(3):787–800. [PubMed]
  • Labelle H, Guibert R, Joncas J, Newman N, Fallaha M, Rivard CH. Lack of scientific evidence for the treatment of lateral epicondylitis of the elbow. An attempted meta-analysis. J Bone Joint Surg Br. 1992 Sep;74(5):646–651. [PubMed]
  • Smidt Nynke, Assendelft Willem J J, Arola Heikki, Malmivaara Antti, Greens Sally, Buchbinder Rachelle, van der Windt Daniëlle A W M, Bouter Lex M. Effectiveness of physiotherapy for lateral epicondylitis: a systematic review. Ann Med. 2003;35(1):51–62. [PubMed]
  • Vicenzino B, Collins D, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain. 1996 Nov;68(1):69–74. [PubMed]
  • Paungmali Aatit, O'Leary Shaun, Souvlis Tina, Vicenzino Bill. Hypoalgesic and sympathoexcitatory effects of mobilization with movement for lateral epicondylalgia. Phys Ther. 2003 Apr;83(4):374–383. [PubMed]
  • Struijs Peter A A, Damen Pieter-Jan, Bakker Eric W P, Blankevoort Leendert, Assendelft Willem J J, van Dijk C Niek. Manipulation of the wrist for management of lateral epicondylitis: a randomized pilot study. Phys Ther. 2003 Jul;83(7):608–616. [PubMed]
  • Vicenzino B, Paungmali A, Buratowski S, Wright A. Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia. Man Ther. 2001 Nov;6(4):205–212. [PubMed]
  • Haake M, König IR, Decker T, Riedel C, Buch M, Müller H-H. Extracorporeal shock wave therapy in the treatment of lateral epicondylitis : a randomized multicenter trial. J Bone Joint Surg Am. 2002 Nov;84-A(11):1982–1991. [PubMed]
  • Speed CA, Nichols D, Richards C, Humphreys H, Wies JT, Burnet S, Hazleman BL. Extracorporeal shock wave therapy for lateral epicondylitis--a double blind randomised controlled trial. J Orthop Res. 2002 Sep;20(5):895–898. [PubMed]
  • Rompe JD, Hope C, Küllmer K, Heine J, Bürger R. Analgesic effect of extracorporeal shock-wave therapy on chronic tennis elbow. J Bone Joint Surg Br. 1996 Mar;78(2):233–237. [PubMed]
  • Rompe JD, Hopf C, Küllmer K, Heine J, Bürger R, Nafe B. Low-energy extracorporal shock wave therapy for persistent tennis elbow. Int Orthop. 1996;20(1):23–27. [PubMed]
  • Rompe JD, Krischek O, Eysel P, Hopf C, Jage J. Chronische Insertionstendopathie am lateralen Epicondylus humeri. Ergebnisse der extrakorporalen Stosswellenapplikation. Schmerz. 1998 Apr 20;12(2):105–111. [PubMed]
  • Rompe JD, Riedel C, Betz U, Fink C. Chronic lateral epicondylitis of the elbow: A prospective study of low-energy shockwave therapy and low-energy shockwave therapy plus manual therapy of the cervical spine. Arch Phys Med Rehabil. 2001 May;82(5):578–582. [PubMed]
  • Maher Christopher G, Sherrington Catherine, Herbert Robert D, Moseley Anne M, Elkins Mark. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther. 2003 Aug;83(8):713–721. [PubMed]
  • Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Bouter LM, Knipschild PG. The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol. 1998 Dec;51(12):1235–1241. [PubMed]
  • Uniform requirements for manuscripts submitted to biomedical journals. International Committee of Medical Journal Editors. JAMA. 1997 Mar 19;277(11):927–934. [PubMed]
  • Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M, Tugwell P, Klassen TP. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet. 1998 Aug 22;352(9128):609–613. [PubMed]
  • Haker E, Lundeberg T. Is low-energy laser treatment effective in lateral epicondylalgia? J Pain Symptom Manage. 1991 May;6(4):241–246. [PubMed]
  • Haker E, Lundeberg T. Pulsed ultrasound treatment in lateral epicondylalgia. Scand J Rehabil Med. 1991;23(3):115–118. [PubMed]
  • Haker EH, Lundeberg TC. Lateral epicondylalgia: report of noneffective midlaser treatment. Arch Phys Med Rehabil. 1991 Nov;72(12):984–988. [PubMed]
  • Krasheninnikoff M, Ellitsgaard N, Rogvi-Hansen B, Zeuthen A, Harder K, Larsen R, Gaardbo H. No effect of low power laser in lateral epicondylitis. Scand J Rheumatol. 1994;23(5):260–263. [PubMed]
  • Jensen B, Bliddal H, Danneskiold-Samsøe B. Sammenligning af to behandlinger ved lateral humerus epicondylit--"tennisalbue". En randomiseret kontrolleret undersøgelse. Ugeskr Laeger. 2001 Mar 5;163(10):1427–1431. [PubMed]
  • Fink M, Wolkenstein E, Luennemann M, Gutenbrunner C, Gehrke A, Karst M. Chronic epicondylitis: effects of real and sham acupuncture treatment: a randomised controlled patient- and examiner-blinded long-term trial. Forsch Komplementarmed Klass Naturheilkd. 2002 Aug;9(4):210–215. [PubMed]
  • Runeson L, Haker E. Iontophoresis with cortisone in the treatment of lateral epicondylalgia (tennis elbow)--a double-blind study. Scand J Med Sci Sports. 2002 Jun;12(3):136–142. [PubMed]
  • Smidt Nynke, van der Windt Daniëlle A W M, Assendelft Willem J J, Devillé Walter L J M, Korthals-de Bos Ingeborg B C, Bouter Lex M. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet. 2002 Feb 23;359(9307):657–662. [PubMed]
  • Wuori JL, Overend TJ, Kramer JF, MacDermid J. Strength and pain measures associated with lateral epicondylitis bracing. Arch Phys Med Rehabil. 1998 Jul;79(7):832–837. [PubMed]
  • Vicenzino Bill, Brooksbank Jane, Minto Joanne, Offord Sonia, Paungmali Aatit. Initial effects of elbow taping on pain-free grip strength and pressure pain threshold. J Orthop Sports Phys Ther. 2003 Jul;33(7):400–407. [PubMed]
  • Molsberger A, Hille E. The analgesic effect of acupuncture in chronic tennis elbow pain. Br J Rheumatol. 1994 Dec;33(12):1162–1165. [PubMed]
  • Fink M, Wolkenstein E, Karst M, Gehrke A. Acupuncture in chronic epicondylitis: a randomized controlled trial. Rheumatology (Oxford) 2002 Feb;41(2):205–209. [PubMed]
  • Lundeberg T, Abrahamsson P, Haker E. A comparative study of continuous ultrasound, placebo ultrasound and rest in epicondylalgia. Scand J Rehabil Med. 1988;20(3):99–101. [PubMed]
  • Lundeberg T, Haker E, Thomas M. Effect of laser versus placebo in tennis elbow. Scand J Rehabil Med. 1987;19(3):135–138. [PubMed]
  • Vasseljen O, Jr, Høeg N, Kjeldstad B, Johnsson A, Larsen S. Low level laser versus placebo in the treatment of tennis elbow. Scand J Rehabil Med. 1992;24(1):37–42. [PubMed]
  • Basford JR, Sheffield CG, Cieslak KR. Laser therapy: a randomized, controlled trial of the effects of low intensity Nd:YAG laser irradiation on lateral epicondylitis. Arch Phys Med Rehabil. 2000 Nov;81(11):1504–1510. [PubMed]
  • Devereaux MD, Hazleman BL, Thomas PP. Chronic lateral humeral epicondylitis--a double-blind controlled assessment of pulsed electromagnetic field therapy. Clin Exp Rheumatol. 1985 Oct-Dec;3(4):333–336. [PubMed]
  • Grossi E, Monza GC, Pollavini S, Bona L. NSAID ionisation in the management of soft-tissue rheumatism: role played by the drug, electrical stimulation and suggestion. Clin Exp Rheumatol. 1986 Jul-Sep;4(3):265–267. [PubMed]
  • Nirschl Robert P, Rodin Dennis M, Ochiai Derek H, Maartmann-Moe Craig. Iontophoretic administration of dexamethasone sodium phosphate for acute epicondylitis. A randomized, double-blinded, placebo-controlled study. Am J Sports Med. 2003 Mar-Apr;31(2):189–195. [PubMed]
  • Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA. 1995 Feb 1;273(5):408–412. [PubMed]
  • Böddeker I, Haake M. Die extrakorporale Stosswellentherapie zur Behandlung der Epicondylitis humeri radialis. Ein aktueller Uberblick. Orthopade. 2000 May;29(5):463–469. [PubMed]
  • Labelle H, Guibert R. Efficacy of diclofenac in lateral epicondylitis of the elbow also treated with immobilization. The University of Montreal Orthopaedic Research Group. Arch Fam Med. 1997 May-Jun;6(3):257–262. [PubMed]
  • Abbott JH, Patla CE, Jensen RH. The initial effects of an elbow mobilization with movement technique on grip strength in subjects with lateral epicondylalgia. Man Ther. 2001 Aug;6(3):163–169. [PubMed]
  • Binder A, Hodge G, Greenwood AM, Hazleman BL, Page Thomas DP. Is therapeutic ultrasound effective in treating soft tissue lesions? Br Med J (Clin Res Ed) 1985 Feb 16;290(6467):512–514. [PMC free article] [PubMed]
  • Melikyan EY, Shahin E, Miles J, Bainbridge LC. Extracorporeal shock-wave treatment for tennis elbow. A randomised double-blind study. J Bone Joint Surg Br. 2003 Aug;85(6):852–855. [PubMed]
  • Verhaar JA, Walenkamp GH, van Mameren H, Kester AD, van der Linden AJ. Local corticosteroid injection versus Cyriax-type physiotherapy for tennis elbow. J Bone Joint Surg Br. 1996 Jan;78(1):128–132. [PubMed]
  • Vicenzino B, Collins D, Benson H, Wright A. An investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation. J Manipulative Physiol Ther. 1998 Sep;21(7):448–453. [PubMed]
  • Chard MD, Hazleman BL. Pulsed electromagnetic field treatment of chronic lateral humeral epicondylitis. Clin Exp Rheumatol. 1988 Jul-Sep;6(3):330–332. [PubMed]
  • Haker E, Lundeberg T. Laser treatment applied to acupuncture points in lateral humeral epicondylalgia. A double-blind study. Pain. 1990 Nov;43(2):243–247. [PubMed]
  • Haker E, Lundeberg T. Acupuncture treatment in epicondylalgia: a comparative study of two acupuncture techniques. Clin J Pain. 1990 Sep;6(3):221–226. [PubMed]
  • Johannsen F, Gam A, Hauschild B, Mathiesen B, Jensen L. Rebox: an adjunct in physical medicine? Arch Phys Med Rehabil. 1993 Apr;74(4):438–440. [PubMed]
  • Klaiman MD, Shrader JA, Danoff JV, Hicks JE, Pesce WJ, Ferland J. Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Med Sci Sports Exerc. 1998 Sep;30(9):1349–1355. [PubMed]
  • Tsui Paul, Leung Mason C P. Comparison of the effectiveness between manual acupuncture and electro-acupuncture on patients with tennis elbow. Acupunct Electrother Res. 2002;27(2):107–117. [PubMed]
  • Vecchini L, Grossi E. Ionization with diclofenac sodium in rheumatic disorders: a double-blind placebo-controlled trial. J Int Med Res. 1984;12(6):346–350. [PubMed]
  • Crowther MAA, Bannister GC, Huma H, Rooker GD. A prospective, randomised study to compare extracorporeal shock-wave therapy and injection of steroid for the treatment of tennis elbow. J Bone Joint Surg Br. 2002 Jul;84(5):678–679. [PubMed]
  • Demirtaş RN, Oner C. The treatment of lateral epicondylitis by iontophoresis of sodium salicylate and sodium diclofenac. Clin Rehabil. 1998 Feb;12(1):23–29. [PubMed]
  • Curković B, Domljan Z. Radijalni epidondilitis. Prospektivna komparativna studija tri nacina lijecenja. Reumatizam. 1986;33(5-6):126–129. [PubMed]
  • Pienimäki T, Karinen P, Kemilä T, Koivukangas P, Vanharanta H. Long-term follow-up of conservatively treated chronic tennis elbow patients. A prospective and retrospective analysis. Scand J Rehabil Med. 1998 Sep;30(3):159–166. [PubMed]
  • Simunovic Z, Trobonjaca T, Trobonjaca Z. Treatment of medial and lateral epicondylitis--tennis and golfer's elbow--with low level laser therapy: a multicenter double blind, placebo-controlled clinical study on 324 patients. J Clin Laser Med Surg. 1998 Jun;16(3):145–151. [PubMed]
  • Svernlöv B, Adolfsson L. Non-operative treatment regime including eccentric training for lateral humeral epicondylalgia. Scand J Med Sci Sports. 2001 Dec;11(6):328–334. [PubMed]
  • Buchbinder Rachelle, Ptasznik Ronnie, Gordon Jeanine, Buchanan Joylene, Prabaharan Vasuki, Forbes Andrew. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: a randomized controlled trial. JAMA. 2002 Sep 18;288(11):1364–1372. [PubMed]
  • Gerdesmeyer Ludger, Wagenpfeil Stefan, Haake Michael, Maier Markus, Loew Markus, Wörtler Klaus, Lampe Renee, Seil Romain, Handle Gerhart, Gassel Susanne, et al. Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial. JAMA. 2003 Nov 19;290(19):2573–2580. [PubMed]
  • Smidt Nynke, van der Windt Daniëlle A W M, Assendelft Willem J J, Devillé Walter L J M, Korthals-de Bos Ingeborg B C, Bouter Lex M. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet. 2002 Feb 23;359(9307):657–662. [PubMed]

Articles from British Journal of Sports Medicine are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...