Cyriax Physiotherapy Versus Phonophoresis with Supervised Exercise in Subjects with Lateral Epicondylalgia: A Randomized Clinical Trial

AMIT V. NAGRALE, CHRISTOPHER R. HERD, SHYAM GANVIR, GOPICHAND RAMTEKE,

The purpose of this RCT was to compare the effectiveness of deep transverse friction massage with Mill's manipulation versus phonophoresis with supervised exercise in managing lateral epicondylalgia. Sixty patients age 30-60, presenting with the teno- periosteal variety of lateral epicondylalgia with symptom duration received either phonophoresis with diclofenac gel over the area of the lateral epicondyle for 5 minutes combined with supervised exercise or 10 minutes of deep transverse friction massage followed by a single application of Mill's manipulation. Both groups received treatment 3 times per week for 4 weeks.  Whereas both groups improved significantly from the initiation of treatment, a between- group comparison revealed significantly greater (p<0.05) improvements regarding pain, pain-free grip, and functional status for the experimental group compared to the control group.

The results of this study demonstrate that Cyriax physiotherapy is a superior treatment approach compared to phonophoresis and exercise in managing lateral epicondylalgia.

JMMT, 22 June 2009, online article ahead of print

Link to abstract