The effects of splinting on outcomes for epicondylitis.

Objective: To evaluate the effects of splinting on outcomes for injured workers with epicondylitis.

Design: Retrospective cohort study using propensity score methodology to statistically control for all observed pretreatment differences between patients with and without splints.

Setting: Nationwide network of 253 occupational medicine clinics.

Participants: All injured workers (N=4614) receiving primary care for lateral or medical epicondylitis (International Classification of Diseases, 9th Revision, codes 726.31 or 726.32).

Interventions: Not applicable.

Main Outcome Measures: Physician-prescribed rates of duty restrictions and lost time, treatment duration, specialist referrals, and medical and physical therapy (PT) visits and charges.

Results: Overall, patients with splints had higher rates of limited duty ( P <.001), more medical visits and charges ( P <.001), higher total charges (medical and PT, P <.001), and longer treatment durations ( P <.01) than patients without splints. Evaluating differences for patients who did and did not receive PT, significant differences remained for rates of limited duty ( P <.05), medical visits ( P <.01), and medical charges ( P <.01).

Conclusions: Splinting patients with epicondylitis may not optimize outcomes, including rates of limited duty, treatment duration, and medical costs.