Elbow
Iontophoresis in lateral epicondylitis: a randomized, double-blind clinical trial

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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).

Section snippets

Study design

This is a double-blind, randomized clinical trial conducted at the Clinical School of Physiotherapy of the Lutheran University of Brazil (ULBRA) in Torres City, Rio Grande do Sul, Brazil. The study was registered in the Brazilian Registry of Clinical Trials (REBEC-RBR-26gq5n).

Sample randomization

Eligible participants were randomized by means of sealed envelopes by an independent researcher, being randomly divided into 2 groups: iontophoresis group (n = 12) and galvanic current group (n = 12). The study participant

Results

The study had a total sample of 24 participants randomly assigned to the iontophoresis group (n = 12) and galvanic current group (n = 12). Table I shows the initial characteristics of the sample. The groups were homogeneous regarding the analyzed variables.

There was a significant reduction in pain at rest in both intervention groups (P < .05). However, at the end of the study, the iontophoresis group showed a significantly lower pain level than the galvanic current group (P = .002) (Fig. 2).

Discussion

In the present study, we investigated the effect of iontophoresis on pain reduction, functionality, and handgrip strength in individuals with LE. The high incidence of tendinous lesions in the population and the failure rate of up to 25% in conservative treatments available for this type of lesions have made this field one of the most interesting for alternative biological approaches.17 However, multiple randomized controlled trials for nonsurgical management of LE do not provide conclusive

Conclusion

Iontophoresis proved to be an effective technique in reducing pain and improving strength and function in individuals with LE.

Disclaimer

The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

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    The study was approved by the Ethics and Research Committee of the Lutheran University of Brazil (CEP opinion number: 2.152.774).

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