Zusammenfassung
Laterale Epikondylitis wird allgemein mit Kortikosteroidinjektionen oder mit Physiotherapie
behandelt. Holländische klinische Richtlinien empfehlen eine Abwartestrategie. Die
Wirksamkeit dieser Ansätze wurde miteinander verglichen.
Die Patienten sollten gut über Vor- und Nachteile von Behandlungsoptionen bei lateraler
Epikondylitis informiert sein. Die Entscheidung, mit Physiotherapy zu behandeln oder
eine Abwartestrategie einzunehmen, kann von den vorhandenen Ressourcen abhängen, da
der relative Vorteil der Physiotherapie gering ist.
Abstract
Lateral epicondylitis is generally treated with corticosteroid injections or physiotherapy.
Dutch clinical guidelines recommend a wait-and-see policy. The efficacy of these approaches
was compared.
Patients should be properly informed about the advantages and disadvantages of the
treatment options for lateral epicondylitis. The decision to treat with physiotherapy
or to adopt a wait-and-see policy might depend on available resources, since the relative
gain of physiotherapy is small.
Schlüsselwörter
Laterale Epikondylitis - Kortikosteroidinjektionen - Physiotherapie - Abwartestrategie
Key words
Lateral epicondylitis - corticosteroid injections - physiotherapy - wait-and-see-policy
Literatur
1
Allander E.
Prevalence, incidence and remission rates of some common rheumatic diseases and syndromes.
Scand J Rheumatol.
1974;
9
145-153
2
Assendelft W JJ, Hay E M, Adshead R. et al .
Corticosteroid injections for lateral epicondylitis: a systematic overview.
Br J Gen Pract.
1996;
9
209-216
3
Beckerman H, Bouter L M, van der Heijden G J. et al .
Efficacy of physiotherapy for musculoskeletal disorders: what can we learn from research?.
Br J Gen Pract.
1993;
9
73-77
4
Binder A, Hodge G, Greenwood A M. et al .
Page TDP. Is therapeutic ultrasound effective in treating soft tissue lesions?.
BMJ.
1985;
9
512-514
5
Chard M D, Hazleman B L.
Tennis elbow: a reappraisal.
Br J Rheumatol.
1989;
9
187-190
6
Cyriax J H.
The pathology and treatment of tennis elbow.
J Bone Joint Surg.
1936;
9
921-940
7
de Wolf A N, van Meurs A J.
Kleine kwalen: de tennis elleboog.
Ned Tijdschr Geneeskd,.
1984;
9
2191-2194
8 de Wolf A N, Mens J AM. Musculoskeletal disorders in general practice (holländisch). Houten/Diegem;
Bohn Stafleu Van Loghum 1995
9
Ernst E.
Conservative therapy for tennis elbow.
Br J Clin Pract.
1992;
9
55-57
10
Ernst E.
Mini review: use a new treatment while it still works - ultrasound for epicondylitis.
Eur J Phys Med.
1994;
9
50-51
11
Fischer A A.
Pressure algometry over normal muscles: standard values, validity and reproducibility
of pressure threshold.
Pain.
1987;
9
115-126
12
Hamilton P G.
The prevalence of humeral epicondylitis: a survey in general practice.
J R Coll Gen Pract.
1986;
9
464-465
13
Hay E M, Paterson S M, Lewis M. et al .
Pragmatic randomised controlled trial of local corticosteroid injection and naproxen
for treatment of lateral epicondylitis of elbow in primary care.
BMJ.
1999;
9
964-968
14
Hudak P L, Cole D C, Haines T.
Understanding prognosis to improve rehabilitation: the example of lateral elbow pain.
Arch Phys Med Rehabil.
1996;
9
586-593
15
Kivi P.
The etiology and conservative treatment of humeral epicondylitis.
Scand J Rehab Med.
1982;
9
37-41
16
Labelle H, Guibert R, Joncas J. et al .
Lack of scientific evidence for the treatment of lateral epicondylitis of the elbow:
an attempted meta-analysis.
J Bone Joint Surg.
1992;
9
646-651
17
Mens J MA.
Kliniek en therapie van de tenniselleboog.
Mod Med.
1993;
9
41-47
18
Miedema H S.
Reuma-onderzoek meerdere echelons: basisrapport.
Leiden: Nederlands Instituut voor Praeventieve Gezondheidszorg TNO.
1994;
19
Murtagh J E.
Tennis elbow.
Aust Fam Physician.
1988;
9
90-95
20
Nussbaum E L, Downes L.
Reliability of clinical pressure: pain algometric measurements obtained on consecutive
days.
Phys Ther.
1998;
9
160-169
21
Pienimäki T, Tarvainen T K, Siira P T. et al .
Progressive strengthening and stretching exercises and ultrasound for chronic lateral
epicondylitis.
Physiotherapy.
1996;
9
522-530
22
Rabkin J G, Markowitz, Stewart J. et al .
How blind is blind? Assessment of patient and doctor medication guesses in a placebo-controlled
trial of impramine and phenelzine.
Psychol Res.
1986;
9
75-86
23 Smidt N, van der Windt D AWM, Mourits A JJM. et al .Interobserver reproducibility
of the assessment of severity of complaints, grip strength, and pressure pain threshold
in patients with lateral epicondylitis. Smidt N. Conservative treatments for tennis
elbow in primary care Wageningen; Ponsen & Looijen BV 2001
24
Stratford P, Levy D R, Levy K. et al .
Extensor carpi radialis tendonitis: a validation of selected outcome measures.
Physiother Can.
1987;
9
250-255
25
Stratford P, Norman G R, McIntosh J M.
Generalizability of grip strength measurements in patients with tennis elbow.
Phys Ther.
1989;
9
276-281
26
Stratford P, Levy D R.
Assessing valid change over time in patients with lateral epicondylitis at the elbow.
Clin J Sport Med.
1994;
9
88-91
27 Verhaar J AN. Tennis elbow. Maastricht:. University Press 1992
28
Verhaar J AN, Walenkamp G H, van Mameren H. et al .
Local corticosteroid injection versus cyriax-type physiotherapy for tennis elbow.
J Bone Joint Surg.
1996;
9
128-132
29
van der Windt D AWM, Koes B W, Devillé W JM. et al .
Effectiveness of corticosteroid injections versus physiotherapy for treatment of painful
stiff shoulder in primary care: randomised trial.
BMJ.
1998;
9
1292-1296
30
van der Windt D AWM, van der Heijden G J, van den Berg S GM. et al .
Ultrasound therapy for musculoskeletal disorders: a systematic review.
Pain.
1999;
9
257-271
Nynke Smidt, PhD
Institute for Research in Extramural Medicine
VU University Medical Center
van der Boechorststr 7
NL-1081 BT Amsterdam
eMail: n.smidt.emgo@med.vu.nl