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da Luz DC, de Borba Y, Ravanello EM, et al. Iontophoresis in lateral epicondylitis: a randomized, double-blind clinical trial. J Shoulder Elbow Surg. 2019 Sep;28(9):1743-1749. doi: 10.1016/j.jse.2019.05.020. (Original study)
Abstract

BACKGROUND: Lateral epicondylitis (LE) is a painful condition typically caused by excessive use of tendons, resulting in tendinopathy, inflammation, pain, and sensitivity changes in the lateral elbow. Iontophoresis is a noninvasive method of systemic and local drug delivery by means of a current. The study aimed to evaluate the effects of iontophoresis in patients with LE.

METHODS: We performed a randomized, double-blind clinical trial. Twenty-four patients with LE, randomized into an iontophoresis group and a galvanic current group. The iontophoresis group received a solution of dexamethasone (4 mg/mL) and gel lidocaine-applied on the negative electrode by means of a continuous current at 5 mA for 15 minutes-and the positive electrode received a base gel solution. Patients in the galvanic current group received the same protocol but using a base gel solution on both electrodes.

RESULTS: Both groups showed a significant improvement in pain on exertion and rest; increased handgrip strength in elbow extension and flexion; and improved function, as evaluated by the Patient-Rated Tennis Elbow Evaluation scale (P < .05). Iontophoresis showed superior results compared with galvanic current in pain on exertion and rest and in the function of individuals with tennis elbow.

CONCLUSION: Iontophoresis proved to be an effective technique in reducing pain and improving strength and function in individuals with LE (tennis elbow).

Ratings
Discipline Area Score
Physician 4 / 7
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Comments from MORE raters

Physician rater

This study included follow up at 6 weeks. Previous studies of steroid injection for lateral epicondylitis demonstrated short term improvement and no intermediate or long term benefit. The follow here is too short to warrant change in clinical practice.

Physician rater

As a GP or family Physician, to provide iontophoresis, using a combination of lidocaine and dexamethasone is not easily available and would require both training and appropriate equipment to deliver. The study yields promising results but is small and would be very difficult to recreate without the equipment, which is more of a physiotherapy thing.

Physician rater

The graphical presentation of the treatment results are clear. Iontophoresis is working better. No need to add more words.

Physician rater

The authors performed a randomized, double-blind clinical trial including twenty-four patients with lateral epicondylitis (LE). The patients were randomized into an iontophoresis group and a galvanic current group. The iontophoresis group received a solution of dexamethasone (4 mg/mL) and gel lidocainedapplied on the negative electrode by means of a continuous current at 5 mA for 15 minutes and the positive electrode received a base gel solution. Patients in the galvanic current group received the same protocol but using a base gel solution on both electrodes. Clinical assessment included the Patient-Rated Tennis Elbow Evaluation scale. Both groups showed a significant improvement in pain on exertion and rest, increased hand grip strength in elbow extension and flexion, and improved function. Iontophoresis showed superior results compared with galvanic current in pain on exertion and rest and in the function, proving to be an effective technique in the treatment of tennis elbow.
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