Common tennis elbow treatments cost-effective
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For relieving painful tennis elbow, a new study has found no difference between the clinical or cost effectiveness of wearing a brace or participating in physical therapy—or a combination of the two.
So the question of which approach is best for treating this common ailment, which strikes 1 percent to 3 percent of the general population each year, remains unanswered, Dr. P.A.A. Struijs of the Academic Medical Center in Amsterdam and colleagues conclude.
Several studies of different methods for treating tennis elbow, including corticosteroid injections and a “wait and see” approach as well as bracing or physical therapy, have been unable to show that any one approach is more effective or cheaper than any other, Struijs and his team note in the British Journal of Sports Medicine.
To investigate, the researchers randomized 180 people with tennis elbow to wear a brace for six weeks, participate in nine sessions of physical therapy over a six-week period, or use a brace and undergo physical therapy. Researchers followed up with study participants at 6, 26 and 52 weeks after the beginning of treatment.
According to the team, there were no statistically significant differences in total costs, including the direct costs of treatment and indirect costs such as sick leave, between the three treatment approaches.
Moreover, one year after treatment, the researchers found, there was no difference between the three groups in terms of the effectiveness of the treatment.
While the direct costs for the physical therapy group were higher, the researchers note, indirect costs were greater for those who used a brace only, which suggests that physical therapy brought people back to work earlier. However, they add, this is a hypothetical observation that the current study cannot prove.
“Future research should focus on patients whose complaints have not resolved after a wait and see policy,” the researchers conclude, adding that additional studies should also look at how quickly people recover after different types of treatment and whether certain subgroups may benefit more from certain therapies.
SOURCE: British journal of Sports Medicine, July 2006.
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