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Hypoalgesic and Sympathoexcitatory Effects of Mobilization With Movement for Lateral Epicondylalgia

A Paungmali, PT, MPT, is a doctoral student, Department of Physiotherapy, The University of Queensland, St Lucia, Queensland, Australia
S O'Leary, PT, MPT, MAPA, is a doctoral student, Department of Physiotherapy, The University of Queensland
T Souvlis, PT, BPT (Hons), MAPA, MPAA, is Lecturer, Physiotherapy Department, The University of Queensland. She was a doctoral student, Department of Physiotherapy, The University of Queensland, at the time of this study
B Vicenzino, PT, PhD, MAPA, MPAA, is Senior Lecturer, Department of Physiotherapy, Director, Musculoskeletal Pain and Injury Research Unit, The University of Queensland, St Lucia, Queensland, Australia, 4072 (b.vicenzino{at}mailbox.uq.edu.au).

Address all correspondence to Dr Vicenzino

Background and Purpose. Mulligan has proposed the use of mobilization with movement for lateral epicondylalgia. In this study, mobilization with movement for the elbow was examined to determine whether this intervention was capable of inducing physiological effects similar to those reported for some forms of spinal manipulation. Participants. Seven women and 17 men (mean age=48.5 years, SD=7.2) with chronic lateral epicondylalgia participated in the study. Methods. A placebo, control, repeated-measures study was conducted to evaluate whether mobilization with movement at the elbow produced concurrent hypoalgesia and sympathoexcitation. Results. The treatment demonstrated an initial hypoalgesic effect and concurrent sympathoexcitation. Improvements in pain resulted in increased pain-free grip force and pressure pain thresholds. Sympathoexcitation was indicated by changes in heart rate, blood pressure, and cutaneous sudomotor and vasomotor function. Discussion and Conclusion. This study showed that a mobilization with movement treatment technique exerted a physiological effect similar to that reported for some spinal manipulations.

Key Words: Lateral epicondylalgia • Manual therapy • Mechanism • Pain • Tennis elbow

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				L Bisset, A Paungmali, B Vicenzino, E Beller, and R D Herbert A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia * Commentary Br. J. Sports Med., July 1, 2005; 39(7): 411 - 422. [Abstract] [Full Text] [PDF]