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Lateral Epicondylitis and Physical Exposure at Work? A Review of Prospective Studies and Meta-Analysis

PainSci » bibliography » Descatha et al 2016
Tags: etiology, elbow, injury, pro, arm, limbs, pain problems

One article on PainSci cites Descatha 2016: Tennis Elbow Guide

PainSci notes on Descatha 2016:

This large, high quality meta-analysis confirmed that overuse in the workplace is a major risk factor for tennis elbow. The five studies they analyzed collectively followed thousands of people, identifying 256 cases. Workers who do “strenuous manual tasks involving the elbow and/or hand with a combination of force and posture” are roughly 2-3 times more likely to develop elbow pain than workers who don’t. The data “strongly support the hypothesis of an association between biomechanic exposure involving the wrist and/or elbow at work and incidence of lateral epicondylitis.”

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: In view of recent published studies, a meta-analysis was undertaken on prospective studies in order to assess any association between lateral epicondylitis and physical exposure at work. METHODS: Using the key words "lateral epicondylitis" AND "occupational" AND ("cohort" OR "longitudinal," OR "incidence") without limitations on the language or year of publication, original prospective studies were selected from 4 databases (PubMed, Scopus, Web of Science, and Base de Données de Santé Publique) after 2 rounds (valid design, valid association reported, and valid work exposure). Relevant associations between physical exposure at work and incident lateral epicondylitis were extracted from the articles, and a meta-risk was calculated using the generic variance approach (meta-odds ratios [meta-ORs]). RESULTS: From 2001 to 2014, 5 prospective studies were included. Among 6,922 included subjects (and 3,449 who were followed), 256 cases of incident lateral epicondylitis were diagnosed 2.5-6 years after baseline. All the published studies found a significant estimation of relative risk for a positive association between combined biomechanic exposure involving the wrist and/or elbow and incidence of lateral epicondylitis. The overall meta-OR was 2.6 (95% confidence interval 1.9-3.5), with a low heterogeneity (Q = 1.4, P > 0.05). Funnel plots and Egger's test did not suggest major publication bias. CONCLUSION: The results of this meta-analysis strongly support the hypothesis of an association between biomechanic exposure involving the wrist and/or elbow at work and incidence of lateral epicondylitis.

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