Effectiveness of acupuncture type interventions compared to pharmacological interventions for pain reduction in lateral epicondylitis

Abstract

Background: Lateral epicondylitis (LE) is a widely known condition characterised by reduced productivity and economic losses, particularly in middle-aged individuals. The first-line treatment for LE is conservative, using oral and topical NSAIDs as well as brace use. When first-line treatment fails, invasive second-line treatment options such as steroid injections and acupuncture-type interventions are offered. The author hypothesised that acupuncture-type interventions would be at least as effective as pharmacological interventions for LE in pain-relieving effects. Research question: Are acupuncture-type interventions more effective than pharmacological interventions in reducing pain in lateral epicondylitis? PICO elements: The population studied (P) was individuals with Lateral Epicondylitis. The intervention (I) was acupuncture-type interventions, whilst the comparison (C) was pharmacological interventions. The final outcome (O) was pain reduction. Inclusion and exclusion criteria: Inclusion criteria: ages 18-70, both genders, LE diagnosis, afflicted for more than 1 month, acupuncture-type interventions, pharmacological interventions, pain relief was measured. Exclusion criteria: languages other than the English language, contraindications to any type of acupuncture/pharmacological intervention, other elbow pathologies, secondary research. Outcomes of the search: Searches to identify relevant studies were done in 7 databases. A total of 7 RCTs and 1 Retrospective cohort study involving 755 individuals were included in this PICO study. Methods of the appraisal used: The CASP Tool was used to assess and critical appraise the methodological quality of the studies. Results: 6 out of the 8 articles chosen reported that acupuncture-type interventions outperformed pharmacological interventions in pain reduction in the long-term. 1 study’s results were statistically insignificant, and the other study reported that pharmacological interventions outperformed acupuncture. Conclusions: Although no definitive conclusion could be reached, it can be stated that acupuncture-type interventions do reduce pain in LE based on the evidence gathered. Further research, however, is required to answer the research question. Implications and recommendations: More research with larger sample sizes is required for consistent results.