Steroid Injection Therapy is the Best Treatment for Lateral Epicondylitis
Steroid Injection Therapy is the Best Treatment for Lateral Epicondylitis
The relative merits of a watch and wait policy, physiotherapy alone, steroid injection therapy alone, and physiotherapy and steroid injection therapy combined, for the treatment of tennis elbow, were assessed using a prospective randomised controlled trial (RCT) of factorial design. Although RCTs comparing different treatment strategies for tennis elbow have previously been published, to our knowledge none of the previous studies have combined the modalities of physiotherapy and steroid injection as one of the treatment groups, as we have done in this study. Patients who received steroid injection were statistically significantly better for all outcome measures at follow up. No statistically significant effect of physiotherapy nor interaction between physiotherapy and injection was found. On the basis of the results of this study, the authors advocate steroid injection alone as the first line of treatment for patients presenting with tennis elbow demanding a quick return to daily activities.
First described as a clinical entity by Runge in 1873, 'tennis elbow' also known as lateral epicondylitis or lateral epicondylalgia, are terms used to describe a myriad of symptoms about the lateral aspect of the elbow. Tennis elbow is the most commonly diagnosed elbow condition and has an incidence of four new cases per thousand annually. Peak incidence is at 40–50 years of age, and for women of 42–46 years of age the incidence increases to 10% . The colloquial term 'tennis elbow' persists despite the fact that fewer than 10% of all patients with the condition are tennis players. Whilst randomised controlled trials (RCTs) comparing conservative treatments for this common condition have been performed previously, to our knowledge, none of the previous studies have combined the modalities of physiotherapy and steroid injection therapy as one of the treatment groups for comparison. This study addresses this shortcoming and explored whether combining these two treatment modalities conferred further benefits to patients with respect to pain relief and improvement of function in the upper limb affected by tennis elbow.
Summary and Introduction
Summary
The relative merits of a watch and wait policy, physiotherapy alone, steroid injection therapy alone, and physiotherapy and steroid injection therapy combined, for the treatment of tennis elbow, were assessed using a prospective randomised controlled trial (RCT) of factorial design. Although RCTs comparing different treatment strategies for tennis elbow have previously been published, to our knowledge none of the previous studies have combined the modalities of physiotherapy and steroid injection as one of the treatment groups, as we have done in this study. Patients who received steroid injection were statistically significantly better for all outcome measures at follow up. No statistically significant effect of physiotherapy nor interaction between physiotherapy and injection was found. On the basis of the results of this study, the authors advocate steroid injection alone as the first line of treatment for patients presenting with tennis elbow demanding a quick return to daily activities.
Introduction
First described as a clinical entity by Runge in 1873, 'tennis elbow' also known as lateral epicondylitis or lateral epicondylalgia, are terms used to describe a myriad of symptoms about the lateral aspect of the elbow. Tennis elbow is the most commonly diagnosed elbow condition and has an incidence of four new cases per thousand annually. Peak incidence is at 40–50 years of age, and for women of 42–46 years of age the incidence increases to 10% . The colloquial term 'tennis elbow' persists despite the fact that fewer than 10% of all patients with the condition are tennis players. Whilst randomised controlled trials (RCTs) comparing conservative treatments for this common condition have been performed previously, to our knowledge, none of the previous studies have combined the modalities of physiotherapy and steroid injection therapy as one of the treatment groups for comparison. This study addresses this shortcoming and explored whether combining these two treatment modalities conferred further benefits to patients with respect to pain relief and improvement of function in the upper limb affected by tennis elbow.
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