Conservative Treatment of Lateral

Lateral epicondylitis, or “tennis elbow, ” is a frequently reported condition in medical care. The complaint is char-acterized by pain over the lateral epicondyle of the humerus, which is aggravated with resisted dorsiflexion of the wrist.5 The incidence in general practice is approxi-mately 4 to 7 per 1000 patients per year with an annual incidence of 1 % to 3 % in the general population.1,4 In the Netherlands, in approximately 10 % of the patients the complaint will result in sick leave, for a mean period of 11 weeks.20 Untreated, the complaint is estimated to last from 6 months to 2 years.5,9,11 Several treatment options are available,7 including an expectant policy, corticosteroid injections, orthotic devices, surgery, and physiotherapeutic modalities such as exercises, ultrasound, laser, massage, electrotherapy, and manipulations. In Dutch primary care, 21 % of the patients with lateral epicondylitis are pre-scribed an orthotic device as a treatment strategy,20 and many different types of braces and other orthotic devices are available for treating tennis elbow.17 The main type is a band or strap around the muscle belly of the wrist exten-sors. Theoretically, binding the muscle with a clasp, band, or brace should limit expansion and thereby decrease the contribution to force production by muscle fibers proximal to the band.8,21 A recent trial by Smidt et al15 compared physical thera-py with an expectant waiting policy and corticosteroid injections. From the results of this trial, the authors con