Elbow Pain

Clin Rheumatol. 2006 Apr 22; [Epub ahead of print]

Effectiveness of pulsed electromagnetic field therapy in lateral epicondylitis.

Uzunca K, Birtane M, Tastekin N.

Trakya University Medical Faculty Physical Medicine and Rehabilitation Department, Edirne, Turkey, druzunca@yahoo.com

We aimed to investigate the efficacy of pulsed electromagnetic field (PEMF) in lateral epicondylitis comparing the modality with sham PEMF and local steroid injection. Sixty patients with lateral epicondylitis were randomly and equally distributed into three groups as follows: Group I received PEMF, Group II sham PEMF, and Group III a corticosteroid + anesthetic agent injection. Pain levels during rest, activity, nighttime, resisted wrist dorsiflexion, and forearm supination were investigated with visual analog scale (VAS). Pain threshold on elbow was determined with algometer. All patients were evaluated before treatment at the third week and the third month. VAS values during activity and pain levels during resisted wrist dorsiflexion were significantly lower in Group III than Group I at the third week. Group I patients had lower pain during rest, activity and nighttime than Group III at third month. PEMF seems to reduce lateral epicondylitis pain better than sham PEMF. Corticosteroid and anesthetic agent injections can be used in patients for rapid return to activities.

J Hand Ther. 2004 Apr-Jun;17(2):243-66.

Rehabilitation for patients with lateral epicondylitis: a systematic review.

Trudel D, Duley J, Zastrow I, Kerr EW, Davidson R, MacDermid JC.

Canadian Forces Base Kingston, Ontario, Canada.

The purpose of this systematic review was to determine the effectiveness of conservative treatments for lateral epicondylitis and to provide recommendations based on this evidence. Five reviewers searched computerized bibliographic databases for articles on the conservative treatment of lateral epicondylitis from the years 1983 to 2003. A total of 209 studies were located; however, only 31 of these met the study inclusion criteria. Each of the articles was randomly allocated to reviewers and critically appraised using a structured critical appraisal tool with 23 items. Treatment recommendations were based on this rating and Sackett’s Level of Evidence. This review has determined, with at least level 2b evidence, that a number of treatments, including acupuncture, exercise therapy, manipulations and mobilizations, ultrasound, phonophoresis, Rebox, and ionization with diclofenac all show positive effects in the reduction of pain or improvement in function for patients with lateral epicondylitis. There is also at least level 2b evidence showing laser therapy and pulsed electromagnetic field therapy to be ineffective in the management of this condition. Practitioners should use the treatment techniques that have strongest evidence and ensure that studies findings are generalized to patients who are similar to those reported in primary research studies in terms of patient demographics and injury presentation

Ortop Travmatol Protez. 1990 Jul;(7):33-5.

Use of electromagnetic feedback in the rehabilitation of children with injuries of the elbow joint.

[Article in Russian]

Iakovlev NM, Solov’ev OA, Chuzhov AL, Smetankin AA.


The paper is devoted to the non-drug functional treatment of children with elbow joint damages by the use of portable self-contained device, based on the principle of electromagnetic feedback. It is demonstrated that sending of artificial feedback signals (light, sound) at the moment of arbitrary contraction of the muscles being trained during 8-10 treatment procedures ensures restoration of muscular-articular sense, strength, endurance of weakened muscle groups, normalizes volume of motion in the elbow joint.

Clin Exp Rheumatol. 1985 Oct-Dec;3(4):333-6.

Chronic lateral humeral epicondylitis–a double-blind controlled assessment of pulsed electromagnetic field therapy.

Devereaux MD, Hazleman BL, Thomas PP.


Pulsed electromagnetic fields (PEMF) have been shown to be beneficial in the treatment of rotator cuff tendinitis. As lateral humeral epicondylitis (tennis elbow) is a similar chronic tendon lesion, 30 patients with both clinical and thermographic evidence of tennis elbow were randomly allocated to receive either active or inactive PEMF therapy. Treatment was continued for a minimum period of eight weeks. At this time there was no statistical difference between the two groups.