Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial

Smidt, Nynke; Windt, D.A.W.M. van der; Assendelft, W.J.J.; Devillé, W.L.J.M.; Bos, Ingeborg B C Korthals-de; Bouter, Lex M.

doi:10.1016/s0140-6736(02)07811-x

Cited by 665 publications

(546 citation statements)

References 19 publications

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“…Os efeitos a longo prazo do uso de corticosteróides são menos favoráveis que a curto prazo (58) . Porém, quando o corticosteróide é aplicado na região peritendínea, pode trazer efeitos bené-ficos (59) .…”

Section: Tratamento Conservadorunclassified

Tendinopatia patelar

Cohen¹,

Ferretti²,

Marcondes³

et al. 2008

Rev. bras. ortop.

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RESUMOA tendinopatia do patelar ou jumper's knee (joelho do saltador) é uma afecção que acomete freqüen-temente atletas praticantes de atividades de salto ou aquelas que exigem força de impacto repetitivo. Histologicamente, a sobrecarga excessiva no tendão pode provocar alterações na matriz extracelular, resultando em pequenas lesões que, cronicamente, poderão levar a um quadro de tendinose, principalmente na região do pólo inferior da patela. A dor na região anterior do joelho é o primeiro sintoma relatado pelo paciente portador dessa afecção. Seu início é insidioso e gradual, principalmente após atividade física, mas, com a progressão da doença, pode tornar-se freqüente durante ou já no início da

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Section: Tratamento Conservadorunclassified

Tendinopatia patelar

Cohen¹,

Ferretti²,

Marcondes³

et al. 2008

Rev. bras. ortop.

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“…A wide variety of non-surgical treatments are available, including ultrasound, non-steroidal anti-inflammatory drugs, corticosteroid injections, a forearm brace or orthotics, stretching, eccentric exercise, and taping 2,[20][21][22][23][24] . Oral and topical non-steroidal antiinflammatory drugs and corticosteroid injection may be helpful for breaking the pain cycle 25) .Smidt compared the efficacy of physiotherapy and corticosteroid injections and found that corticosteroid injection was superior to all other therapies; however, corticosteroid treatment was associated with a high recurrence rate 26) .…”

Section: Introductionmentioning

confidence: 99%

Effects of Taping on Wrist Extensor Force and Joint Position Reproduction Sense of Subjects With and Without Lateral Epicondylitis

Lee

Jeon

et al. 2011

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to assess the effect of taping on wrist extensor force reproduction (FR) and wrist joint position reproduction (JPR) sense in subjects with and without lateral epicondylitis. [Subjects] Thirty workers in an automobile-parts manufacturing company participated: fifteen workers who had experienced pain with lateral epicondylitis and fifteen workers who had no history of lateral epicondylitis.[Methods] Taping was applied on the proximal forearm, starting from the medial, and tracking laterally. This was repeated two or three times.The FR error and JPR error of both groups (with and without lateral epicondylitis) were measured with and without taping.[Results] Without taping, the FR and JPR errors of the lateral epicondylitis group were significantly higher than those of the without lateral epicondylitis group.With taping, the FR error of the lateral epicondylitis group was significantly decreased from 1.24 kg to 0.49 kg. With taping, the JPR error of the lateral epicondylitis group was significantly decreased from 3.31 to 2.13 degrees.[Conclusion] The lateral epicondylitis group had significantly higher FR and JPR errors. Taping significantly improved force reproduction and joint position reproduction error.

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“…A diferença estimada na alteração desta escala (IC 95%) comparativamente à avaliação inicial pré-intervenção foi de -2,4 (-8,1 a 3,4) às quatro semanas de seguimento e -2,9 (-9,0 a 3,2) às 12 semanas. 20 Em relação à perspectiva do doente, dos três estudos que analisaram a satisfação global do doente, 14,15,17 um apresenta uma média de satisfação de 3,97 (DP 2,26) numa escala numérica em que zero corresponde a 'não satisfeito' e seis a 'muito satisfeito'; 14 noutro estudo o índice de satisfação às seis semanas foi de 90% (DP 16%) e às 52 semanas de 77% (DP 23%) num universo de 62 doentes avaliados.…”

Section: Resultsunclassified

“…15 Os efeitos adversos ligeiros atribuídos às infiltrações de corticosteróides, a nível sistémico, incluíram afrontamentos, [13][14][15][16][17]19 alterações do ciclo menstrual, 13,16,17 Os três estudos de custo-efectividade analisaram os encargos financeiros e o efeito das infiltrações peri-articulares de corticósteroides na qualidade de vida dos indivíduos com síndrome do ombro doloroso, sendo que nenhum dos estudos fez referência a efeitos adversos. [21][22][23] O estudo de James et al mostrou encargos financeiros totais, por doente, de 100,50€ para o grupo sujeito a infiltrações e 161,59 € para o grupo submetido a fisioterapia, sendo a diferença média, por doente, de 61,08 € (IC 95%, 22,86 € a 95,92 €).…”

Section: Resultsunclassified

Infiltração Peri-Articular de Corticosteróides na Abordagem da Patologia Músculo- Esquelética em Medicina Geral e Familiar: Uma Revisão Sistemática

Trindade¹

2015

Acta Med Port

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Introduction: Periarticular corticosteroid injection utilization by General Practitioners treating musculoskeletal disease in primary health care system is internationally acknowledged. This article aims at analyzing this evidence and contributing to the discussion of a potential development of the technique in Portugal. Material and Methods: Qualitative analysis of randomized control trials, cost-effectiveness studies, cross-sectional studies, retrospective cohort studies and observational studies, using PRISMA model. Data Sources: PubMed, Cochrane Library and Essential Evidence Plus. Eligibility criteria: corticosteroid injection mention in the treatment of musculoskeletal disease and an element that indicates primary health care context. Results: Nine randomized control trials, three cost-effectiveness studies, three cross-sectional studies, three descriptive studies and one retrospective cohort study were reviewed. Most success parameters of corticosteroid injections performed by general practitioners showed short term efficacy; at long term they did not outstand other therapeutic options. The balance between the economic burden ascribed to this technique utilization in primary health care context and gain in subject's quality of life is favorable. The eleven studies assessing security registered only minor side effects and no serious ones. Discussion: The periarticular corticosteroid injection technique performance places it as a therapeutic option treating musculoskeletal disease in Portuguese primary health care. Nevertheless further evidence is required to support its efficacy and safety parameters, namely at national level. Conclusion: Corticosteroid injection utilization in primary health care constitutes an effective and safe option, with the potential to improve primary health care service rendering in an economically sustainable way.

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Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial

Abstract: Patients should be properly informed about the advantages and disadvantages of the treatment options for lateral epicondylitis. The decision to treat with physiotherapy or to adopt a wait-and-see policy might depend on available resources, since the relative gain of physiotherapy is small.

Cited by 665 publications

References 19 publications

Tendinopatia patelar

Tendinopatia patelar

Effects of Taping on Wrist Extensor Force and Joint Position Reproduction Sense of Subjects With and Without Lateral Epicondylitis

Infiltração Peri-Articular de Corticosteróides na Abordagem da Patologia Músculo- Esquelética em Medicina Geral e Familiar: Uma Revisão Sistemática

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