Corticosteroid injection in early treatment of lateral epicondylitis.
OBJECTIVE
To analyze whether a corticosteroid injection in combination with rehabilitation early in the course of lateral epicondylitis (LE) alters the outcome up to 6 months after injection compared with a control injection and rehabilitation.


METHODS
Randomized, controlled, double-blind study.


METHODS
Sports medicine center in a tertiary care center.


METHODS
Subjects with a diagnosis of LE whose symptoms had been present less than 4 weeks were included. Subjects were recruited by word of mouth and through advertising. The 39 subjects who were recruited were 18 to 65 years old.


METHODS
19 subjects were randomized to receive rehabilitation and a sham injection, and 20 were randomized to receive rehabilitation and a corticosteroid injection. At 4 and 8 weeks, they were reevaluated and their treatment programs were modified, if indicated.


METHODS
Outcome measurements were performed at baseline, 4 weeks, 8 weeks, and 6 months, and included a functional pain questionnaire and a visual analogue pain scale. Painless grip strength on the affected side and maximal grip strength bilaterally were measured at baseline, 4 weeks, and 8 weeks.


RESULTS
There were no significant differences in outcome between the two groups with the exception of an improvement in the visual analogue pain scale in the corticosteroid group from 8 weeks to 6 months. Outcome measurements in both groups improved significantly over time; more than 80% of subjects reported improvements from baseline to 6 months for all scales.


CONCLUSIONS
A corticosteroid injection does not provide a clinically significant improvement in the outcome of LE, and rehabilitation should be the first line of treatment in patients with a short duration of symptoms.
Newcomer
K L
KL
Department of Physical Medicine and Rehabilitation, and Section of Biostatistics, Mayo Clinic, Rochester, Minnesota 55905, USA. newcomer.karen@mayo.edu
Laskowski
E R
ER
Idank
D M
DM
McLean
T J
TJ
Egan
K S
KS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001265:Athletic Injuries / Q000188:drug therapy* / Q000534:rehabilitation; D001623:Betamethasone / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage; D017679:Cryotherapy / Q000379:methods; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D007839:Functional Laterality; D018737:Hand Strength; D006801:Humans; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D013716:Tennis Elbow / Q000188:drug therapy* / Q000534:rehabilitation; D013995:Time; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D001623:Betamethasone; D002045:Bupivacaine