Case report
Chiropractic Treatment of Lateral Epicondylitis: A Case Report Utilizing Active Release Techniques

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Abstract

Objective

The purpose of this report is to describe the chiropractic management of a case of lateral epicondylitis with active release techniques (ART).

Clinical features

A 48-year-old white man presented to a chiropractic clinic with a complaint of left lateral elbow pain that began 2 years previous with insidious onset. The patient reported an inability to play 18 consecutive holes of golf due to the pain.

Intervention and outcome

Treatment consisted of 5 sessions of ART (a soft tissue technique that is applied to muscles, fascia, tendons, ligaments, and nerves) applied to the left elbow soft tissue over a duration of 3 weeks. The patient reported an absence of pain and ability to consistently play 18 consecutive holes of golf up to 3 times per week at 4 and 8 weeks post-treatment.

Conclusion

This patient with lateral epicondylitis responded favorably to chiropractic treatment using the application of ART, as demonstrated by reduced pain and increased functional outcomes.

Introduction

Lateral epicondylitis, commonly known as tennis elbow, is described as a painful condition affecting the lateral aspect of the elbow that is aggravated by active and resisted wrist extension and direct palpation of the lateral epicondyle of the humerus, the radiohumeral joint space, or the proximal forearm extensor muscles.1, 2, 3, 4 This condition is most notably reported in athletes participating in racquet sports such as tennis. However it has been reported to affect other athletes as well such as golfers.5, 6, 7 Despite its well known relationship with athletes, lateral epicondylitis is primarily seen in workers engaging in repetitive rotation, extension and/or flexion of the forearm. It has been reported that lateral epicondylitis affects 1% to 3% of the general population and affects women more so than men.5, 8, 9, 10, 11, 12, 13

Generally, lateral epicondylitis is considered a self-limiting condition and recovery is seen with 1-2 years of conservative management. In some instances the condition may continue longer, with approximately 10% of cases requiring surgical treatment.14, 15, 16, 17 The choices of conservative treatment options are diverse and best management strategies remain controversial.9 This may be due to a current absence of universally accepted pathophysiological understanding, poor or biased methods of current studies, the existence of multiple variables which may influence outcomes, and the mere self-limiting character of the condition.18, 19

This study describes the chiropractic management of a patient with chronic lateral epicondylitis using the application of active release techniques (ART).

Section snippets

Case Report

A 48-year-old white man presented to a chiropractic clinic with left lateral elbow pain. The complaint originated 2 years previously with an insidious onset. Self-management strategies including over-the-counter non-steroidal anti-inflammatory medication, ice, and stretching were unsuccessful. The patient reported a slow progression of symptoms culminating in intense pain following playing 18 holes of golf 3 days prior to initial consultation. At the time of presentation, the patient described

Discussion

Chronic tendon injuries are a common reason for presentation to health care providers and may significantly impact one’s ability to work, exercise, and perform routine activities of daily living.21, 22, 23 Lateral epicondylitis is typically attributed to activities that require the repetitive use of the soft tissues. Although chronic tendon injuries, such as lateral epicondylitis, are traditionally described as a “tendonitis”, this term may not be appropriate. The term “epicondylitis” implies a

Limitations

A weakness of this study is a lack of objective outcome measurements utilized throughout the case. As with any single intervention, there is no way to determine the extent to which any individual treatment may or may not have contributed to the perceived beneficial outcome and to what extent the condition self-resolved. The findings from this case may not necessarily be applicable to other similar cases.

Conclusion

In this case, the administration of ART appeared to reduce symptomatology and allow functional restoration for a patient with chronic lateral epicondylitis.

Funding Sources and Conflicts of Interest

No funding sources or conflicts of interest were reported for this study.

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