Cervical manipulation for the treatment of lateral epicondylitis

 

It has been long known that spinal manipulation can effectively treat spinal disorders, but what about manipulation for the treatment of limb pain. A study by Fernandez-de-las-Penas 2007 compared the immediate effects on pressure pain threshold (PPT) tested over the lateral elbow region following a single cervical high-velocity low-amplitude (HVLA) thrust manipulation.

The manipulative intervention targeted C5-6 vertebral level which they found produced an immediate increase in PPT over the lateral epicondyle of both elbows in healthy subjects. C5-6 manipulation demonstrated significant increase in pressure pain threshold levels (PPT) of 35.5% and 24.8% over the ipsilateral and contralateral epicondyles, “whereas effect sizes for both placebo and control procedures were small, suggesting no significant effect.”

If treating cervical dysfunction can result in decreased symptoms in limbs, then it must also be considered as a potential generator of the symptoms. It is common knowledge that core stability and strength can enhance limb function, however a compromised spine can also be a detriment to resolving limb dysfunction. Compression of the nerve root, along with compromised neurodynamics will always be a variable to assess when dealing with limb pain and must be corrected to regain 100% function of the associated limb.

 

Resources: https://www.ncbi.nlm.nih.gov/pubmed/17612359