Treatment of Lateral Epicondylitis With a Percussive Therapy Device

The device the investigators intend to use is Class I and in a class of devices that is exempt from the FDA requirement for premarket notification/approval (exempt from 510K or PMA), which would not be "subject to section 510(k), 515, or 520(m) of the Federal Food, Drug, and Cosmetic Act" (ref: FDAAA Checklist)

• Percussive Therapy Device (Device), also known as Theragun: Same as group description
• Physical Therapy (Behavioral): Same as group description

Primary outcomes

• Time to Improvement of Symptoms [3 months]

Secondary outcomes

• PROMIS Upper Extremity [3 months]: Patient-Reported Outcomes Measurement Information System Upper extremity - 0-100 indicating functionality of the upper extremity with higher scores representing more functionality
• PROMIS Physical Functioning [3 months]: Patient-Reported Outcomes Measurement Information System Physical function 0-100 indicating overall functionality with higher scores representing more functionality
• PROMIS Pain Interference [3 months]: Patient-Reported Outcomes Measurement Information System Pain interference 0-100 measures the extent to which pain hinders an individual's engagement with physical, mental, cognitive, emotional, recreational, and social activities with higher scores representing more interference
• PROMIS Depression [3 months]: Patient-Reported Outcomes Measurement Information System Depression - 0-100 assess self-reported negative mood (sadness, guilt), views of self (self- criticism, worthlessness), and social cognition (loneliness, interpersonal alienation), as well as decreased positive affect and engagement (loss of interest, meaning, and purpose) with higher scores indicating more depression
• VAS pain score [3 months]: Visual Analog Score for pain - subjective measure for acute and chronic pain. Scaled 0-10
• SANE score [3 months]: Single Assessment Numeric Evaluation - This is a single-question outcome measure that asks patients to rate their function, as it pertains to the area being treated, on a scale of 0 to 100

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Individuals 18 years old or older are included
* Patients with atraumatic lateral epicondylitis symptoms
* Symptoms persistent and present for at least 2 weeks
* Presence of 2 of the following on clinical examination: +tenderness to palpation common extensor tendons and/or lateral epicondyle origin, pain over the lateral elbow with passive flexion of the wrist in an extended position, +pain with resisted supination, +pain with resisted middle finger extension.

Exclusion Criteria:

* Any records flagged "break the glass" or "research opt out."
* Patients with elbow osteoarthritis,
* Patients with a history of traumatic injury to the elbow
* Patients with workers compensation
* Patients who received cortisol injection in the elbow
* MRI evidence of common extensor tear
* A history of surgery on the affected elbow,
* Cognitive or behavioral problems which would preclude informed consent.
* Patients with coagulopathies
* Patients who are pregnant
* Patients who had a cortisone injection within 3 months

• Michael A Stone, M.D, Principal investigator, Cedars-Sinai Medical Center