2.2 Participants
fracture, psychiatric, pain
DISEASES
The participants were invited by sending personal email or mobile call and they were recruited from University hospital and King Khalid hospital, Al Kharj, Saudi Arabia by an orthopedic surgeon. They were informed about the harms and benefits of the research through an information form. Subjects who consented to participate in the study were selected for the study and the written informed consent was obtained from all subjects. Male, aged between 18 and 60 years, with a clinical diagnosis of chronic (> 2 months of pain) lateral epicondylalgia (M77.1 in ICD-10 –International classification of diseases), with pain intensity between 3 to 8 on the visual analog scale (VAS) were allowed to participate. Only male subjects were included in this study due to their responses to the interventions when compared to the female participants, which may alter the study reports. Participants with prior steroid injection therapy, associated neck or arm pain, severe musculoskeletal, neural, somatic and psychiatric conditions, waiting for surgery, having alcohol or drug abuse, involving in other weight training programs, and red flags to manipulation were excluded from the study. Participants with other soft tissue injuries, fracture at the limbs, deformities were also excluded from the study.The participants were randomized using computer generated randomization method and allocated into two groups: corticosteroid injection with DTFM and Mill’s manipulation–Active group (n = 30) and Sham group (n = 30) and the flow of study participants was shown in 