It may be time to modify the Cyriax treatment of lateral epicondylitis

Effect of the combined isotonic technique for proprioceptive neuromuscular facilitation and taping on pain and grip strength in patients with lateral epicondylitis: a randomized clinical trial

The purpose of this study was to investigate the effect of the combined isotonic technique (CIT) for proprioceptive neuromuscular facilitation and taping intervention on pain and grip strength in patients with lateral epicondylitis (LE). Twenty subjects with LE were treated 5 times a week for 4 weeks. Patients were randomized to an experimental group (n=10) with taping after CIT and a control group (n=10) with taping after stretching. A visual analogue scale (VAS) was used to measure changes in pain. A hand dynamometer was used to measure grip strength. A paired t-test was performed to compare differences after the intervention. We used an independent t-test to compare the differences between experimental and control groups. All statistical significance levels were set at α=0.05. Within-group changes in VAS and grip strength were significantly different in both the experimental and control groups (P<0.05). Between-groups after intervention, VAS and grip strength showed more improvement in the experimental group than in the control group (P<0.05). This study showed that by applying CIT and taping to patients with LE, significant improvement in pain and grip strength could be obtained. Since the intervention had positive effects on LE by reducing pain and increasing grip strength, additional studies on efficient intervention will be conducted to develop exercise programs.

Cyriax Friction Massage-Suggestions for Improvements

Background and objectives: Cyriax friction massage is a widely known and used technique in the field of chronic pain management. Despite its frequent use in daily clinical practice, the technique lacks evidence to support its therapeutic value. While this might be due to various factors, the authors of this paper suggest that the technique might need to be improved and/or modernized according to the recent literature. The purpose of this letter is to further analyze our point of view. Materials and Methods: Using the most relevant methods to the subject literature, the authors intended to point out a few technical details that might need reconsideration and/or modernization. Results: An appropriate terminology is suggested in the text. Further, suggestions are made regarding the technique's interval time, a possible addition of self-treatment, a discussion of the combination with Mill's manipulation, tendon positioning and other parameters. Conclusions: As a therapeutic value has not yet been clearly documented, and since the modernization and/or improvement of the technique might be needed, we suggest that this technique should not be used as a first-line treatment for the management of chronic pain.