Long-term effectiveness of conservative management for lateral epicondylitis: a meta-analysis

Qiaojie Chen; Pingping  Shen; Bo  Zhang; Yang  Chen; Chunli  Zheng

doi:10.2340/jphs.v58.12333

Authors

Qiaojie Chen Department of Orthopedics, Ningbo No.2 Hospital, Ningbo, China
Pingping Shen Department of Gastroenterology, Ningbo Yinzhou No.2 Hospital, Ningbo, China
Bo Zhang Department of Orthopedics, Ningbo No.2 Hospital, Ningbo, China
Yang Chen Department of Orthopedics, Ningbo No.2 Hospital, Ningbo, China
Chunli Zheng Department of TCM Rehabilitation, Ningbo No.2 Hospital, Ningbo, China

DOI:

https://doi.org/10.2340/jphs.v58.12333

Keywords:

lateral epicondylitis, tennis elbow, conservative management, therapy, interventions, treatment

Abstract

Objective: To investigate the long-term (>12 months) effectiveness of conservative management for lateral epicondylitis.
Data Sources: PubMed and Embase databases were searched for relevant studies from inception to March 2023.
Study Selection and Data Extraction: Only English-written randomized controlled trial (RCT) with data download as well as follow up ≥12 months were acceptable. Raw data were extracted into a predefined worksheet, and quality analysis was conducted based on the Cochrane risk-of-bias tool version 2 (RoB2).
Data Synthesis: The standardized mean difference (SMD) with 95% confidence interval (CI) were calculated.
Results: Extracorporeal shock wave therapy (ESWT) could significantly relive pain for lateral epicondylitis patients in the long term (SMD: −0.19, 95% CI [−0.36, −0.02]); however, there was no significant difference between ESWT and control groups in long-term function outcome (SMD: 0.24, 95% CI [−0.02, −0.49]). No significant difference could be observed between (1) exercise and control groups in pain (SMD: −0.21, 95% CI [−0.60, 0.18]) or function (SMD: 0.06, 95% CI [−0.11, 0.23]), (2) corticosteroids and placebo groups in pain (SMD: 0.70, 95% CI [−0.43, 1.82]) or function (SMD: −0.02, 95% CI [−0.36, 0.31]), and (3) platelet-rich plasma (PRP) in pain (SMD: −0.30, 95% CI [−0.85, 0.25]) and function (SMD: −0.08, 95% CI [−0.78, 0.62]).
Conclusion: The present conventional conservative management for lateral epicondylitis, with the exception
of ESWT, a lack adequate evidence supporting their long-term effectiveness.

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