A sample case: Epicondylitis

Greetings followers! Let’s have a little look at a specific case study a common musculoskeletal condition. Tennis elbow is the most common condition of the elbow in adults and as seen in the proceeding study can be significantly improved through the use of iontophoresis.

Method:

·         18-75 yrs old clinical signs leading to la dx of medial or lateral epicondylitis

·         patients were randomized into one of two groups: dermal inotophoretic administration of of dexamethasone sodium phosphate 0.4% injection or dermal inotophorectic administration of bacteriostatic sodium chloride injection 0.9%

·         2.5ml of each solution was administered using IOMED phoresor inotophorectic drug delivery system. Solution was instilled into a gel sponge pad

·         40mA-minutes treatment spaced 1 to 3 days apart six treatments completed within 15 day period

Results:


FIGURE 1: Summary of efficacy results by length of time in which patients completed treatments. VAS, visual analog scale score.



·         Patients receiving dexamethasone significantly improved in their visual analog scale score

·         Forty-eight percent of the dexamethasone group and 41% of the placebo group had a score of moderate or better for the patient global evaluation of improvement

·        Patients who completed all six treatments in 10 days or less showed better results than did patients who completed all six treatments over a longer period

Discussion:

The patient’s receiving six iontophoresis treatments of 40mA-minutes were effective in reducing symptoms of medial or lateral epicondylitis particularly when treatments were completed in 10 days or less. Due to no restrictions from using other treatment modalities throughout the trial patients may have also been administering anti-inflammatory medication, steroidal injections or therapeutic exercise which could have altered assessment of symptoms compared to the sole use of iontophoresis.

Still to come are what we are convinced to be the most significant pros and cons of iontophoresis…… Stay tuned!

REFERENCE

Nirschl, R., Rodin, D., Ochiai D. & Maartmann-Moe, C. (2003). Iontophoretic Administration of Dexamethasone Sodium Phosphate for Acute Epicondylitis. The American Journal of Sports Medicine, 31(2), 189-195.