Does Adding Cryostimulation to Conservative Care Help in Managing Chronic Lateral Epicondylitis? a Pilote Study
Does Adding Cryostimulation to Conservative Care Help in Managing Chronic Lateral Epicondylitis? a Pilote Study
In this study the investigators want to measure the impact or effects of adding
 cryostimulation to the conservative care of chronic lateral epicondylitis. The rapid fall in
 skin temperature above the injured tissues is presume to have a positive effect in the
 healing process. The combination of conservative care and cryostimulation could then be
 appreciated. The investigators chose to measure these effects with 3 elements: visual analog
 pain scale, validated elbow questionnaire and pain free grip strength. This pilot study
 consist in a two arm design, each arm including 15 patients.
Lateral epicondylitis is one of the most prevalent upper limb conditions that can affect up
 to 1-3% of the active population. Invalidity and health care costs incurred by this condition
 are posing a real challenge to our societies knowing that the natural history of the lateral
 epicondylitis can last from 1 to 2 years. Many therapies have been tested and so far none has
 proven conclusive when used alone so far (Blanchette and Normand 2011). The use of
 cryostimulation is widespread in the sport scene without strong literature supporting its
 evidence. The aim of this study is to quantify the effects of cryostimulation when added to
 conservative care in the treatment of chronic lateral epicondylitis.

 Thirty (30) patients will be divided randomly in two groups:

 -  The control group (n=15) will receive conservative care including myofascial trigger
 points (involved forearm) and radial head mobilisations (Bergmann & Peterson, 2010).

 -  The experimental group (n=15) will receive the cryostimulation and the conservative
 treatment as mentioned above.

 A total of eight treatments will be given to each patient; the whole protocol lasting four to
 six weeks. The treatments will be delivered by experienced and trained clinicians in
 cryostimulation and myofascial treatment protocols.

 The effects of the two treatment protocols will be monitored by a validated elbow
 questionnaire (PRTEE, (Rompe, Overend et al. 2007)), a visual analog pain scale and the pain
 free grip strength at three moments: at inclusion, at the ninth visit and 3 months after the
 last treatment.
Inclusion Criteria:

 -  Must have pain at lateral elbow (lateral epicondylitis) for at least six months

 -  Pain must not come from trauma

 -  Painful palpation of the lateral epicondyle

 -  At least one out of two positive test: Cozen's, Mill's

 Exclusion Criteria:

 -  Fibromyalgia

 -  Diabetes

 -  Patient taking more than three medications at the time of inclusion

 -  Cervical radiculopathy

 -  Painful shoulder

 -  Cold intolerance / allergies

 -  Smoking

 -  Cortisone infiltration at the painful lateral epicondyle in the month previous to the
 inclusion