LATERAL EPİKONDİLİTTE FİZİK TEDAVİ VE STEROİD ENJEKSİYONUNUN ETKİNLİĞİNİN KARŞILAŞTIRILMASI

Yıl 2020, Cilt: 15 Sayı: 3, 54 - 59, 16.10.2020

Pınar Mazlum Macit Gonca Sağlam Akın Erdal

https://doi.org/10.17517/ksutfd.726160

Cited By: 1

Öz

AMAÇ: Bu randomize kontrollü çalışmada lateral epikondilitte lokal steroid enjeksiyonu ile terapötik pulse ultrason ve parafin tedavisinin etkinliklerini karşılaştırma amaçlandı.
GEREÇ VE YÖNTEMLER: Otuz altı lateral epikondilit teşhisi konulan hasta randomize olarak 18’er kişilik iki gruba ayrıldı. 1. gruba lokal steroid enjeksiyonu uygulanırken, 2. gruba pulse ultrason ve parafin tedavisi verildi. Hastalar başlangıçta, 3. haftada ve 6. haftada değerlendirildi. Başlangıçta ve takiplerdeki ağrı düzeyleri, istirahat ve aktivitede Vizüel Analog Skala ve Likert skalası ile sorgulandı. Kontrollerde; basınçla ve dirence karşı el bileği ekstansiyonu ile gelişen ağrı, elin sıkma gücü, hasta ve hekimin global değerlendirmesi kaydedildi.
BULGULAR: Tedavilerin sonunda her iki grupta da tüm ağrı parametlerinde azalma ve el kavrama gücünde artış izlendi. 3. ve 6. haftalardaki tespit edilen iyileşme bakımından gruplar arası anlamlı fark görülmedi.
SONUÇ: Lateral epikondilitte steroid enjeksiyonu ve ultrason ile parafin tedavileri etkin bir şekilde kullanılabilir. Ağrıda hızlı azalma için ucuz ve pratik olan steroid enjeksiyonu tercih edilebilir.

Anahtar Kelimeler

lateral epikondilit, terapötik ultrason, parafin, steroid enjeksiyonu

Kaynakça

• 1. Runge F. "Zur genese und behandlung des schreibekrampfes." Berl Klin Wochenschr 10 (1873): 245-248.
• 2. Mandiroğlu S, Bal A, Gurçay E, Çakcı A. Comparison of the effects of non-steroidal anti-inflammatory drugs, steroid injection and physical therapy in lateral epicondylitis. Turk J Phys Med Rehab 2007;53:104-7.
• 3. Akpınar S, Hersekli MA, Demirörs H. Lateral epikondilitte artroskopik gevşetme (olgu sunumu). Artroplasti Artroskopik Cerrahi 2001; 12: 87-90.
• 4. Nirschl RP. Elbow tendinosis/tenis elbow. Clin Sport Med 1992; 11: 851-870.
• 5. Kraushaar BS, Nirschl RP. Tendinosis of the elbow (tenis elbow): Clinical features and findings of histological immunohistochemical and electron microscopy studies. J Bone Joint Surg 1999; 81: 259-279.
• 6. Shiri R,Viikari-Juntura E, Varonen H, Heliövaara M. Prevalance and determinants of lateral and medial epicondylitis:a population study.AmJj Epidemiol 2006;164(11):1065-74
• 7. Johnson GW, Cadwallader K, Scheffel SB, Epperly TD. (2007). Treatment of lateral epicondylitis. American family physician 76(6).
• 8. Ahmad Z, Siddiqui N, Malik SS, Abdus-Samee M, Tytherleigh-Strong G, Rushton N. Lateral epicondylitis: a review of pathology and management. Bone Joint J 2013;95:1158-64
• 9. Buchanan BK, Huhges J. "Tennis Elbow (Lateral Epicondylitis)." StatPearls [Internet]. StatPearls Publishing, 2017.
• 10. Vaquero-Picado A, Barco R, Antuña SA. "Lateral epicondylitis of the elbow." EFORT open reviews 1.11 (2016): 391-397.
• 11. Osborne H. "Stop injecting corticosteroid into patients with tennis elbow, they are much more likely to get better by themselves!." Journal of science and medicine in sport 13.4 (2010): 380-381.
• 12. Ben-Nafa W, Munro W. "The effect of corticosteroid versus platelet-rich plasma injection therapies for the management of lateral epicondylitis: A systematic review." SICOT-J 4 (2018).
• 13. Sirico F, Ricca F, MeglioF DI, Nurzynska D, Castaldo C, Spera R, et al. "Local corticosteroid versus autologous blood injections in lateral epicondylitis: meta-analysis of randomized controlled trials." European journal of physical and rehabilitation medicine 53.3 (2017): 483-491.
• 14. Coombes BK, Bisset L, Vicenzino B. "Management of lateral elbow tendinopathy: one size does not fit all." journal of orthopaedic & sports physical therapy 45.11 (2015): 938-949.
• 15. Ahmad Z, Siddiqui N, Malik SS, Abdus-Samee M, Tytherleigh-Strong G, Rushton N. Lateral epicondylitis: a review of pathology and management." The bone & joint journal 95.9 (2013): 1158-1164.
• 16. Sims SEG, Miller K, Elfar JC, Hammert WC."Non-surgical treatment of lateral epicondylitis: a systematic review of randomized controlled trials." Hand 9.4 (2014): 419-446.
• 17. Verhaar JAN, Walenkamp G, Mameren H, Kester ADM, Van der Linden AJ. "Local corticosteroid injection versus Cyriax-type physiotherapy for tennis elbow." The Journal of bone and joint surgery. British volume 78.1 (1996): 128-132.
• 18. Tonks JH, Pai SK, Murali SR. "Steroid injection therapy is the best conservative treatment for lateral epicondylitis: a prospective randomised controlled trial." International journal of clinical practice 61.2 (2007): 240-246.
• 19. Ergan T. Lateral epikondilitlerde fizik tedavi ile lokal kortikosteroid enjeksiyonunun etkilerinin karşılaştırılması. Haydarpaşa Numune hastanesi FTR Kliniği. Uzmanlık Tezi, İstanbul 1991
• 20. Dijs H, Mortier G, Driessens M. A retrospective study of the conservative treatment of tennis elbow. Acta BelgMed Phys. 1990; 13(2): 73-7.
• 21. Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ 2006;333:939-41.
• 22. Jensen B, Bliddal H, Danneskiold-Samsoe B. Comparison of two different treatments of lateral humeral epicondylitis “tennis elbow”. A randomised controlled trial. Ugeskr Laeger 2001; 163(10): 1427-31.
• 23. Toker S, Kılınçoğlu V, Aksakallı E, Gulcan E, Ozkan K. Short term results of treatment of tennis elbow with anti-inflammatory drugs alone or in combination with local injection of a corticosteroid and anesthetic mixture. Acta Orthop Traumatol Turc 2008; 42(3): 184-187.
• 24. Sims SE, Miller K, Elfar JC, Hammert WC. Non-surgical treatment of lateral epicondylitis: a systematic review of randomized controlled trials. Hand (N Y) 2014; 9: 419-446 [PMID: 25414603 DOI: 10.1007/s11552-014-9642-x]
• 25. Weber C, Thai V, Neuheuser K, Groover K, Christ O. Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis. BMC Musculoskelet Disord 2015; 16: 223 [PMID: 26303397 DOI: 10.1186/s12891-015-0665-4]
• 26. Menta R, Randhawa K, Côté P, Wong JJ, Yu H, Sutton D, et al. The effectiveness of exercise for the management of musculoskeletal disorders and injuries of the elbow, forearm, wrist, and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration. J Manipulative Physiol Ther 2015; 38: 507-520
• 27. Binder A, Hodge G, Greenwood AM, Hazleman BL, Thomas DP. "Is therapeutic ultrasound effective in treating soft tissue lesions?." Br Med J (Clin Res Ed) 290.6467 (1985): 512-514.
• 28. Akın C, Öken Ö, Köseoğlu F. "Short-term effectiveness of ultrasound treatment in patients with lateral epicondylitis: randomized, single-blind, placebo-controlled, prospective study." Archives of Rheumatology 25.2 (2010): 050-055.
• 29. Struijs PA, Damen PJ, Bakker EWP, Blankevoort L, Assendelft WJ, van Dijk CN. Manipulation of the wrist for management of lateral epicondylitis: a randomised pilot study.Phys Ther. 2003; 608-616
• 30. Kocabağlı ÖS. Lateral epikondilit tedavisinde Ultrason, TENS ve plasebo ultrason karşılaştırması. Uludağ Üniversitesi Tıp Fak. Uzmanlık tezi, Bursa 1990
• 31. Gündüz R. Physical therapy, corticosteroid injection and extracorporeal shock wave treatment in lateral epicondylitis. Clin Rheumatol. 2012; 31: 807–812
• 32. Smidt N, Assendelft WJ, van der Windt DA, Hay EM, Buchbinder R, Bouter L. Corticosteroid injections for lateral epicondylitis: a systematic review. Pain 2002;96:23-40
• 33. Murtezani A, Ibraimi Z, VIIasoolli TO. "Exercise and Therapeutic Ultrasound Compared with Corticosteroid Injection for Chronic Lateral Epicondylitis: A Randomized Controlled Trial." Ortopedia, traumatologia, rehabilitacja 17.4 (2015): 351-357.
• 34. Abdulkadir A, Atiç R. "Comparison of extracorporeal shock-wave therapy and wrist-extensor splint application in the treatment of lateral epicondylitis: a prospective randomized controlled study." Journal of pain research 11 (2018): 1459
• 35. Vicenzino B, Britt H, Pollack AJ, Hall M, Bennell KL, Hunter DJ. "No abatement of steroid injections for tennis elbow in Australian General Practice: A 15-year observational study with random general practitioner sampling." PloS one 12.7 (2017): e0181631.