Update on lateral elbow pain: from research to clinical practice

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Background

Chronic elbow pain reflects a range of common musculoskeletal injuries that is often debilitating and significantly impacts sporting and working careers. While the clinical presentation may seem simple, differences in the underlying pathophysiology and the complexity of differential diagnoses make elbow injuries difficult to assess and treat. While pain in elbow injuries such as tennis elbow was once thought to be driven exclusively by local nociception, emerging evidence of central sensitisation and altered pain processing belies the complexity of the underlying aetiology and the difficulty faced by clinicians in managing these conditions. We proposed an integrative model to conceptualise the contribution of the sensory, motor, and pain systems in the development and maintenance of chronic pain associated with an elbow injury. Understanding the contribution of local tissue pathology, sensory and motor system impairments to the individual’s clinical presentation will assist clinicians in implementing an effective treatment program. Knowledge of possible differential diagnoses is essential in the development of advanced clinical reasoning required to assess and diagnose sport-related elbow injuries, particularly those not associated with a traumatic injury. With early and accurate diagnosis, there is a growing body of evidence to support the use of conservative management (i.e., physiotherapy) as the first-line approach to treating chronic pain associated with elbow injuries.

Relevance to Physiotherapy Practice

Effective management of elbow injuries requires a sound knowledge of the anatomy, pathology and physiology of the elbow and appropriate assessment and treatment skills. The aim of this webinar is to provide physiotherapists with an opportunity to improve their knowledge and clinical reasoning relevant to the assessment and treatment of common elbow injuries.

Learning Objectives

1. Explain the relationship between local tissue pathology, and sensorimotor impairments and the clinical presentation of elbow pain

2. Summarise the evidence regarding aetiology and predictors of recovery in people with elbow injuries

3. Synthesise the research evidence evaluating a range of treatments (conservative, injection, surgical) for elbow injuries

4. Translate the evidence into clinical practice and clinical reasoning of evidence-based treatment options, including the importance of the multi-disciplinary team management of patients with elbow injuries

Speaker's Biography

Leanne Bisset PhD, MPhty (Manips), MPhty (Sports), BPhty, Musculoskeletal and Sports Physiotherapist (as Titled by the Australian Physiotherapy Association).

Leanne is an Associate Professor in Musculoskeletal Physiotherapy, Discipline Lead and Program Director of the Bachelor of Physiotherapy within the School of Allied Health Sciences at Griffith University. Leanne also maintains a part-time clinical practice with a Specialist referral base of complex upper limb injuries. She holds two postgraduate Masters degrees (Musculoskeletal and Sports Physiotherapy) and has more than 25 years' clinical experience in musculoskeletal/sports physiotherapy practice. Leanne completed her PhD from the University of Queensland (Australia) in 2008. In collaboration, she has successfully completed multiple clinical trials investigating physiotherapy and medical interventions for chronic upper limb musculoskeletal pain conditions. Leanne has published extensively, with 4 book chapters (including Grieves Modern Musculoskeletal Physiotherapy. 4^th Ed) and over 60 peer-reviewed journal articles with >3,000 citations. Leanne has supervised 1 MPhil and 7 PhD students to completion and is currently supervising 1 Masters and 4 PhD students. With more than AUD$2 million in competitive grant funding and multiple invitations to present her Elbow Course around Australia and internationally, Leanne is recognised as a leading expert in the field of non-traumatic elbow injuries.