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Can lateral epicondylitis be relief by osteopathic treatments targeting tensions from the thoracic region? Results of a case study

Journal: Journal of Complementary and Integrative Medicine Date: 2018/12, 15(4):Pages: eA8. doi: Subito , type of study: case report

Free full text   (https://www.degruyter.com/document/doi/10.1515/jcim-2018-2000/html)

Keywords:

case report [693]
chronic pain [274]
elbow [32]
lateral epicondylitis [5]
OMT [3661]
osteopathic manipulative treatment [3683]

Abstract:

Background: Lateral epicondylitis (LE) is a musculoskeletal disorder causing pain in the lateral aspect of the elbow. This pain associated with a reduction in grip strength can limit the activities of daily life or sport performance. It becomes difficult to perform various activities such as turning a door handle, opening a jar, shaking hands, carrying groceries or lifting a cup of coffee. Few studies have examined the effects of osteopathic treatments in cases of chronic LE that have not been completely relieved by conventional treatment in physiotherapy. Objectives: The objective of this case study is to determine whether LE that has been present for at least 6 months may be relief by osteopathic treatment of tensions coming from the thoracic region. Methods: The case study was conducted on a subject suffering from chronic LE of the left elbow for 6 months and having previously received 4 treatments in physiotherapy. To alleviate the pain at the elbow, 4 osteopathic treatments have been applied. Measurements included: grip strength (dynamometer), strength of the extensor muscles of the wrist (muscle strength grading scale), range of motion of the elbow (goniometer), global pain and pain on palpation around the lateral epicondyle (visual analog scale) and special tests (Cozen, Mills and Maudlsey) for the diagnosis of LE. The evaluation was done before and after each treatment. Results: The first treatment involving the correction of cranial dysfunctions did not significantly improve the patient’s signs and symptoms. The two following treatments, addressing thoracic dysfunctions, yielded significant improvement in grip strength (from 23.3kg to 29.3kg), active (130° to 142°) and passive (133° to 145°) range of motion and global (7/10 to 4/10) and palpation (8/10 to 5/10) pain tests of the left elbow. The last treatment, involving mainly the normalization of the thoracic diaphragm muscle, the pelvic diaphragm and the cranial diaphragm, completely eliminated the patient’s symptoms at the elbow. Conclusion: The findings indicated that LE present for 6 months may have been maintained by tensions coming from the thoracic region. Osteopathic treatment addressing those tensions has completely relief chronic LE pain in this case.


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