Lateral epicondylalgia A new structured treatment program with an inter-disciplinary approach

University dissertation from University of Gothenburg

Abstract: Conclusion: Interdisciplinary cooperation in the treatment of patients with acute lateral epicondylalgia benefits the patients by shortening the rehabilitation period and provides health care professionals the opportunity for an improved learning and exchanging experiences. There was a strong will to cooperate and the risks of side effects with corticosteroid injections and NSAID are well-known although they are the most common treatments. Treating the patient at the right level of care could minimize side effects. These basic conditions must be met in order to improve health care quality. Study IV: Aim: To evaluate whether patients with lateral epicondylalgia, two years after they were treated by a structured program, had less pain or function loss and if recurrent episodes and sick-leave days differed compared to a control group. Method: This study had a prospective design with a two year follow-up. The intervention group (n=103) were referred to a physiotherapist and an occupational therapist working together with a structured treatment program. The control group, chosen from the same diagnose code (n=194) were treated with various treatments. The outcome measures were pain, function, rates of recurrences and sick-leave using a questionnaire two years after their visit at the health care center. Result: More than half of the patients experienced some pain and function loss from their elbow. The intervention group had less sick-leave absence at the time for the first visit, less pain and function loss and fewer periods of recurrences and needed less additional therapy if a recurrence occurred. Conclusion: This disease is not always a self-limiting condition and needs treatment. A structured treatment and to teach the patients how to treat themselves if the symptoms re-occur, seems to be an effective way. The patient will not need additional treatment and do not need to be on the sick list. The main findings: With a structured program and by using interdisciplinary cooperation in the treatment of lateral epicondylalgia, the absence from work could decrease, the pain and the function loss was less for the patient, side-effects were minimized and the program could be an outlined and effective way for the health care professionals to treat the patient and to evaluate lateral epicondylalgia both clinical and in science.

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