Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2006 Jul;40(7):637-43; discussion 643.
doi: 10.1136/bjsm.2006.026187. Epub 2006 May 10.

Cost effectiveness of brace, physiotherapy, or both for treatment of tennis elbow

P A A Struijs  1 , I B C Korthals-de Bos, M W van Tulder, C N van Dijk, L M Bouter, W J J Assendelft
Affiliations
Randomized Controlled Trial

Cost effectiveness of brace, physiotherapy, or both for treatment of tennis elbow

P A A Struijs et al. Br J Sports Med. 2006 Jul.

Abstract

Background: The annual incidence of tennis elbow in the general population is high (1-3%). Tennis elbow often leads to limitation of activities of daily living and work absenteeism. Physiotherapy and braces are the most common treatments.

Objectives: The hypothesis of the trial was that no difference exists in the cost effectiveness of physiotherapy, braces, and a combination of the two for treatment of tennis elbow.

Methods: The trial was designed as a randomised controlled trial with intention to treat analysis. A total of 180 patients with tennis elbow were randomised to brace only (n = 68), physiotherapy (n = 56), or a combination of the two (n = 56). Outcome measures were success rate, severity of complaints, pain, functional disability, and quality of life. Follow up was at six, 26, and 52 weeks. Direct healthcare and non-healthcare costs and indirect costs were measured. Mean cost differences over 12 months were evaluated by applying non-parametric bootstrap techniques.

Results: No clinically relevant or statistically significant differences were found between the groups. Success rate at 12 months was 89% in the physiotherapy group, 86% in the brace group, and 87% in the combination group. Mean total costs per patient were 2069 euros in the brace only group, 978 euros in the physiotherapy group, and 1256 euros in the combination group. The mean difference in total costs between the physiotherapy and brace group was substantial (1005 euros), although not significant. Cost effectiveness ratios and cost utility ratios showed physiotherapy to be the most cost effective, although this also was not statistically significant.

Conclusion: No clinically relevant or statistically significant differences in costs were identified between the three strategies.

PubMed Disclaimer

Conflict of interest statement

Competing interests: none declared

References

    1. Assendelft W J J, Green S. Tennis elbow. In: Jones R, Britten N, Culpepper L, et al. Oxford textbook of primary medical care. Oxford: Oxford University Press, 20041140–1142.
    1. Cyriax J H. The pathology and treatment of tennis elbow. J Bone Joint Surg [Am] 19364921–940.
    1. Allander E. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scand J Rheumatol 19743145–153. - PubMed
    1. Chard M D, Hazleman B L. Tennis elbow: a reappraisal. Br J Rheumatol 198928186–190. - PubMed
    1. Hudak P L, Cole D C, Haines A T. Understanding prognosis to improve rehabilitation: the example of lateral elbow pain. Arch Phys Med Rehabil 199677586–593. - PubMed

Publication types