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Berger P.1
1University of the Witwatersrand, Physiotherapy Department, Johannesburg, South Africa
Background: Many patients with tennis or golfer's elbow experiencing chronic pain prior to elbow surgery may continue to experience pain, limitation of movement and function, post-operatively. This condition may then require extended physiotherapy with the possiblity of further surgery.
It has been observed that the neurostimulation device in question, has relieved severe pain and improved nerve conduction in various conditions, including those of post surgical conditions and has also improved wound healing.
It has been observed that the neurostimulation device in question, has relieved severe pain and improved nerve conduction in various conditions, including those of post surgical conditions and has also improved wound healing.
Purpose: This case study intended to investigate if patients receiving treatment with the neurostimulation device as their sole treatment immediately post-tennis or golfer´s elbow surgery, would achieve relief of acute and sub-acute post-operative pain and improvement in mobility, function and wound healing. It was thought that early or immediate treatment intervention post-operatively may prevent post-operative pain in this population of patients.
Methods: Post surgery, seven patients were given neurostimulation with three treatments of 20 min each on the brachial plexus during the 10 days before the splint was removed. This was followed by 6 treatments, twice weekly of 20 min each after the splint was removed. At each of these treatments 5-min stimulation was administered to four areas: the nerve supply (1) superior and (2) inferior to the elbow and (3 and 4) on either end of the wound.
Patients were evaluated for pain with the visual analogue scale, movements of flexion and extension measured with a goniometer, strength and flexibility with a 12 point-movement activity scale, status of the wound and satisfaction with treatment, mobility and function. These measures were re-evaluated telephonically at one, three and six months after the last treatment.
Results: Significant pain relief was achieved by all of the seven patients before the splint was removed at the 4th treatment. Pain relief, range of movement and function was greatly improved at the final (9th) treatment by six of the seven patients and this was maintained with nearly full improvement of the above parameters for most of the participants at one month after the last treatment. Two patients had to have re-operation due to requiring further more extensive surgery in the one patient and falling and re- injuring the original surgical site in the other patient. At three and six months after the last treatment full improvement in all the parameters above were maintained in the remaining five patients who also had excellent wound healing, satisfaction with their treatment, mobility and function.
Conclusion(s): It appears that nerve stimulation alone post elbow surgery has the capacity to improve acute post-surgical pain and reduce sub-acute pain, improve mobility and function and stimulate wound healing once the splint was removed.
Implications: A new treatment approach may be available that reduces pain, dysfunction, the period of treatment and rehabilitation in post-operative elbow patients compared with usual physiotherapy.
Funding acknowledgements: Xavant, the company that manufactured the device paid the independent researchers for their testing and treatment of these patients.
Topic: Electrophysical & isothermal agents
Ethics approval: University of the Witwatersrand, Division of the Deputy Registrar (Academic and Research), Ethics Committee
All authors, affiliations and abstracts have been published as submitted.
