title: A randomized clinical trial on comparison of corticosteroid injection with or without splinting versus saline injection with or without splinting in patients with lateral epicondylitis.
abstract: BACKGROUND
  Lateral epicondylitis is a common problem affecting 1-3% of the population. There has been much debate about the best treatment modality for this condition. There is, however, no conclusive evidence in support of any of the proposed treatment modalities. In this trial, we have studied the effect of corticosteroid injection (with or without splinting) with normal saline injection (with or without splinting).
  
  
  METHODS
  In this double-blind, randomized clinical trial, individuals were randomly assigned to either of four treatment groups and received either 40 mg depomedrol injection alone, 40 mg depomedrol injection with splinting, normal saline injection alone, or normal saline injection with splinting. They were evaluated using the visual analog scale (VAS) at weeks 2, 4 and 24 and with the Oxford elbow scale (OES) at 24 weeks.
  
  
  RESULTS
  A total of 79 patients were participated in the study. The corticosteroid injection groups had better pain relief as measured by VAS at 2 and 4 weeks compared with the two saline injection groups. Mean VAS difference at week 0 versus week 2 was 4.5 ± 0.9 and 2.8 ± 0.6 in corticosteroid injection groups and saline injection groups respectively (P < 0.01) but at 24 weeks, there was only moderate benefit reported for the group which received steroid injection and splinting (P < 0.01) compared to the saline injection groups. The saline injection groups reported better improvement in OES scores (20.1 ± 3.7) at the end of the trial compared corticosteroid injection groups (16.1 ± 2.9) (P < 0.05).
  
  
  CONCLUSIONS
  Our results indicate that despite the clear pain reduction benefit associated with steroid injection in short term, this benefit in comparison with normal saline injection fades by the 24(th) week of follow-up.
authors.affiliation: Department of Orthopedics, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Tahririan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Moayednia
authors.affiliation: Department of Physical Medicine and Rehabilitation, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Momeni
authors.affiliation: Department of Physical Medicine and Rehabilitation, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Yousefi
authors.affiliation: Department of Physical Medicine and Rehabilitation, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Vahdatpour
keywords: Corticosteroid; injection; lateral epicondylitis; normal saline