Comparison between 2 groups of chronic lateral epicondylitis, to determine the effect of ozonated media phonophoresis on chronic lateral epicondylitis.

40 patients (male and female), patients age would be ranged from 30 to 50 years, would be randomly allocated using sealed envelope into randomly two matched group (A and B), Group A (Experimental): 20 patients would receive ultrasonic with ozonated gel as a coupling medium (phonophoresis) (1 MHz, 1 W/cm2continuous mode) for 5 min. plus, conventional physical therapy program consists of (conventional TENS (100 Hz) for 30 min - hot pack for 20 min- stretching and strengthening exercises, wrist rest splints). 3 times per week for 4 weeks.

Group B (control):20 patients will receive conventional physical therapy program consists of (conventional TENS (100 Hz) for 30 min - hot pack for 20 min- stretching and strengthening exercises, wrist rest splints) 3times per week for 4 weeks.

Inclusion Criteria:

• All patients would be diagnosed as chronic lateral epicondylitis from both genders.
• Patients with chronic lateral epicondylitis that diagnosed by orthopedist.
• Positive clinical manifestation in all patients.
• Pain onset is more than 3 months.
• All participants must be medically stable and not be treated with analgesics or any medication which may cause misleading results.
• All patients had body mass index between 18.5 and 29.9 kg/m2.

Exclusion Criteria:

• Subjects would be excluded if they have:

Received intra articular injection from duration less than 3 months.

• Elbow instability.
• History of cancer.
• Pregnancy
• Infection.
• Skin diseases on elbow area.
• Open wound in elbow.
• Shoulder or elbow fractures
• Systemic diseases such as rheumatoid arthritis, Reiter's syndrome, or diabetes.
• Neurological diseases.
• Severe medical or psychiatric disorders.
• Elbow surgery.
• Entrapment of the radial nerve.
• Arthritis and effusion of the elbow.

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