Assessment and Management of Lateral Elbow Pain in Physiotherapy Clinical Practice: an Italian National Survey

Introduction. Lateral Elbow Pain (LEP) represents a disabling condition with a 1-3% prevalence in general population and a low spontaneous resolution rate within a year. This study investigated the methods of assessment and management of LEP in a sample of physiotherapists in relation to their level of experience. Methods. We conducted a cross sectional survey consisting of 12 questions. The investigation lasted 2 months and was disseminated through the informative channels of the Italian Physiotherapists Association and by e-mail. The percentage of responses was expressed for different levels of experience in terms of years of work and number of patients with LEP seen in 1 month. Data were analyzed with the SPSS software. Results. 1405 responses were collected. For LEP management, Psycho-Social Factors (PSFs) are more considered by the interviewees with few years of clinical practice than those who have worked for several years (p < 0.001; χ2=36.795); surgery is less considered as a therapeutic option by professionals who see 0-1 patients per month than those who see much more patients (p < 0.001; χ2=20.521). The percentage of use of manual therapy (p=0.017; χ2=32.901) and the use of the Maudsley and SALT tests (p=0.012; χ2=65.360) result higher in the group that sees more than 3 patients per month; corticosteroid infiltrations are not considered useful by those who see more than 3 patients per month compared to those who see 1 patient or none (p < 0.001; χ2=43.632). Conclusions. Despite being aware of the new evidence on the etiology of LEP, only a small percentage of interviewed physiotherapists resort to adequate and specific assessment tools. Clinicians should update their patient management options to better act on the PSFs and mostly consider a multidisciplinary approach to LEP disorders.