Evaluation of treatment preferences among orthopedic surgeons and physical medicine and rehabilitation specialists for lateral epicondylitis: A cross-sectional survey study.

Abstract

Lateral epicondylitis is a common musculoskeletal disorder that lacks a universally accepted treatment algorithm. Thus, management strategies may vary among medical specialties. This study aimed to evaluate current treatment approaches for lateral epicondylitis and compare the preferences of orthopedic surgeons and physical medicine and rehabilitation (PM&R) specialists. A cross-sectional survey was conducted among orthopedic surgeons and PM&R specialists in Türkiye. The questionnaire included items regarding diagnostic methods, treatment preferences, injection practices, and perceptions of injection therapy outcomes. Treatment approaches to lateral epicondylitis were compared between specialties. A total of 101 physicians participated in the study, including 51 orthopedic surgeons and 50 PM&R specialists. Physical examination was the most commonly preferred diagnostic method (98%). The most frequently preferred first-line treatment was a combination of rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy (88.1%). Second-line treatment preferences differed significantly between specialties (P < .001). Orthopedic surgeons more frequently preferred injection therapy (72.5%), whereas PM&R specialists more commonly preferred extracorporeal shock wave therapy (ESWT) (52.0%). PM&R specialists reported transitioning to injection therapy earlier (P = .016) and more frequently reported using ultrasound guidance than orthopedic surgeons (70.2% vs 4.3%, P < .001). No statistically significant between-specialty difference was detected in perceived short-term (P = .224) or long-term (P = .546) effectiveness ratings. The most frequently selected first-line treatment was the same in both specialties, whereas reported second-line treatment preferences differed. Orthopedic surgeons more frequently selected injection therapy, whereas PM&R specialists more frequently selected ESWT. These findings reflect self-reported treatment preferences and perceptions and should not be interpreted as evidence of treatment effectiveness or as nationally representative estimates. Level IV, cross-sectional survey study.