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
. 2009;17(3):171-8.
doi: 10.1179/jmt.2009.17.3.171.

Cyriax physiotherapy versus phonophoresis with supervised exercise in subjects with lateral epicondylalgia: a randomized clinical trial

Amit V Nagrale, Christopher R Herd, Shyam Ganvir, Gopichand Ramteke

Cyriax physiotherapy versus phonophoresis with supervised exercise in subjects with lateral epicondylalgia: a randomized clinical trial

Amit V Nagrale et al. J Man Manip Ther. 2009.

Abstract

Cyriax and Cyriax advocated the use of deep transverse friction massage in combination with Mill's manipulation in treating lateral epicondylalgia. Evidence comparing this approach with other physical therapies is lacking. The purpose of this randomized clinical trial was to compare the effectiveness of deep transverse friction massage with Mill's manipulation versus phonophoresis with supervised exercise in managing lateral epicondylalgia. Sixty patients age 30-60, presenting with the teno-periosteal variety of lateral epicondylalgia with symptom duration greater than one month, were randomized into two groups. The control group received phonophoresis with diclofenac gel over the area of the lateral epicondyle for 5 minutes combined with supervised exercise. The experimental group received 10 minutes of deep transverse friction massage followed by a single application of Mill's manipulation. Both groups received treatment 3 times per week for 4 weeks. Outcomes of interest included pain via visual analog scale (VAS), pain-free grip strength, and functional status measured with the Tennis Elbow Function Scale. Data were analyzed using a one-way ANOVA. Whereas both groups improved significantly from the initiation of treatment, a between-group comparison revealed significantly greater (p<0.05) improvements regarding pain, pain-free grip, and functional status for the experimental group compared to the control group. The results of this study demonstrate that Cyriax physiotherapy is a superior treatment approach compared to phonophoresis and exercise in managing lateral epicondylalgia.

Keywords: Cyriax's Physiotherapy; Lateral Epicondylalgia; Mill's Manipulation; Phonophoresis; Tennis Elbow.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Deep transverse friction massage.
FIGURE 2
FIGURE 2
Near end range of Mill's manipulation.
FIGURE 3
FIGURE 3
Flow of subject inclusion and participation.
FIGURE 4
FIGURE 4
Comparison of VAS (in cms) at baseline and follow-up periods.
FIGURE 5
FIGURE 5
Comparison of pain-free grip strength (in lbs) at baseline and follow-up periods.
FIGURE 6
FIGURE 6
Comparison of Tennis Elbow Function Scale score at baseline and followup periods.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005;39:411–422. - PMC - PubMed
    1. Waugh EJ, Jaglal SB, Davis AM, Tomlinson G, Verrer MC. Factors associated with prognosis of lateral epicondylitis after 8 weeks of physical therapy. Arch Phys Med Rehabil. 2004;85:308–318. - PubMed
    1. Vicenzino B, Wright A. Lateral epicondylalgia I: A review of epidemiology, pathophysiology, aetiology, and natural history. Phys Ther Rev. 1996;1:23–34.
    1. Kraushaar B, Nirschl R. Current concepts review tendinosis of the elbow (tennis elbow): Clinical features and findings of histological immunohistochemical and electron microscopy studies . J Bone Joint Surg Am. 1999;81:259–285. - PubMed
    1. Waugh EJ. Lateral epicondylalgia or epicondylitis: What's in a name? J Orthop Sports Phys Ther. 2005;35:200–202. - PubMed

LinkOut - more resources