Which injections are effective for lateral epicondylitis?

Vukelic, Brian; Abbey, Rebecca; Knox, Jordan; Migdalski, Alyssa; Guthmann, Richard

doi:10.12788/jfp.0308

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…While there is a lack of studies focusing on neural therapy for LE treatment, several studies have evaluated other types of injections [11][12][13][14][15]. These injection treatments are also recommended for patients who do not respond to alternative methods.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of neural therapy injection and extracorporeal shock wave therapy on pain and hand functions in the treatment of lateral epicondylitis

Dönmez¹,

Aygün

2023

J Surg Med

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Background/Aim: Lateral epicondylitis (LE), commonly known as “tennis elbow”, is a painful inflammatory condition affecting wrist extensor tendons. Various treatments, such as extracorporeal shockwave therapy (ESWT) and neural therapy injections, have been used to alleviate symptoms of LE. However, there is a limited number of comparative studies available. This study aims to compare the effectiveness of sequential neural therapy injections and ESWT in reducing pain and improving functionality in patients with LE. Methods: A retrospective cohort study analyzed data from 128 LE patients. Among them, 30 patients underwent neural therapy, while 30 underwent ESWT, following the exclusion criteria. Pain levels were measured using the visual analog scale (VAS), and functionality was assessed using the Duruöz hand index (DHI) before and after treatment. Results: Both neural therapy injections and ESWT led to substantial reductions in pain and improvements in functionality, with no notable differences observed between the two treatment methods. Additionally, no significant variations were found based on age, body mass index, gender, or the side of the elbow treated. Conclusion: The findings suggest that both neural therapy injections and ESWT are equally effective in managing symptoms of LE. Treatment choice may depend on patient preference, cost, availability, or other factors. Further research is necessary to examine long-term outcomes, potential side effects, and factors predicting a better response to one treatment.

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Section: Discussionmentioning

confidence: 99%

Comparison of the effects of neural therapy injection and extracorporeal shock wave therapy on pain and hand functions in the treatment of lateral epicondylitis

Dönmez¹,

Aygün

2023

J Surg Med

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“…Tonks et al thought that steroid injection therapy was the best conservative treatment and that the symptoms of pain could be rapidly relieved during the initial phases of the condition [10]. Some experts suggested that corticosteroid injection should not be used to treat most patients with tennis elbow who exhibit a symptom duration of less than 12 months and that this approach might be less beneficial to the long-term outcomes of the patient [11]. In the long term, physiotherapy became the best option, followed by a wait-and-see policy, but the recovery period was still long [12].…”

Section: Introductionmentioning

confidence: 99%

Comparison between acupotomy and corticosteroid injection for patients diagnosed with different classifications of tennis elbow: a randomized control trial

Liu

Zhang

et al. 2022

J Orthop Surg Res

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Background Tennis elbow has long been one of the most controversial subjects in orthopaedics. Many scholars thought the use of open or arthroscopic surgery was reserved for patients with refractory symptoms. Therapy with percutaneous acupotomy performed under local anaesthesia also removes degenerated tissue, releases strain, and therefore provides an alternative treatment option to surgical excision. Methods The aim of this single-blinded randomized control trial was to examine the long-term clinical effectiveness of a nonsurgical percutaneous release technique (acupotomy) and the current recommended treatment (steroid injection) in people diagnosed with a refractory tennis elbow. Ninety patients with refractory symptoms were included. The intervention period was 6 weeks. According to the classification, 38 patients had extra-articular tennis elbow, 36 patients had intraarticular tennis elbow, and 16 patients had mixed type tennis elbow. Forty-five patients were randomly assigned to treatment with percutaneous release by acupotomy according to their classified condition, and 45 patients were randomly assigned to treatment with steroid injection alone. The visual analogue scale (VAS), a tenderness assessment, a grip assessment, and the Nirschl staging system were used for outcome evaluation at pretreatment and the posttreatment timepoints from 12 to 48 weeks. Results During the first weeks, there were no differences observed between the groups. By 6, 24 and 48 weeks, significant differences were observed between the two groups. The acupotomy group scored significantly better in visual analogue scale score (VAS) of pain, tenderness during palpation, pain-free grip strength (PFGS) and Nirschl staging than the corticosteroid group. Conclusions For patients with lateral epicondylitis, acupotomy is just as effective as corticosteroid injections in the short term (< 6 weeks). In the long term, acupotomy has greater efficacy and is associated with a lower rate of recurrence than corticosteroid injections in the management of lateral epicondylitis. Trial registration: The National Health Commission announced the "ethical review measures for biomedical research involving people" in 2019, which was not mandatory in previous studies.

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“…Tonks et al thought that steroid injection therapy was the best conservative treatment and that the symptoms of pain could be rapidly relieved during the initial phases of the condition [10]. Some experts suggested that corticosteroid injection should not be used to treat most patients with tennis elbow who exhibit a symptom duration of less than 12 months and that this approach might be less bene cial to the long-term outcomes of the patient [11]. In the long term, physiotherapy became the best option, followed by a wait-and-see policy, but the recovery period was still long.…”

Section: Introductionmentioning

confidence: 99%

Effects of a minimally invasive technique for patients diagnosed with different classifications of tennis elbow: A randomized control trial

Cheng

Zhang

et al. 2022

Preprint

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Background Tennis elbow has long been one of the most controversial subjects in orthopaedics. Many scholars thought the use of open or arthroscopic surgery was reserved for patients with refractory symptoms. Therapy with percutaneous acupotomy performed under local anaesthesia also removes degenerated tissue, releases strain, and therefore provides an alternative treatment option to surgical excision. Purpose The aim of this single-blinded randomized control trial was to examine the long-term clinical effectiveness of a nonsurgical percutaneous release technique (acupotomy) and the current standard of care (steroid injection) in people diagnosed with a refractory tennis elbow. Methods Ninety patients with refractory symptoms were included. The intervention period was 6 weeks. According to the classification, 38 patients had extra-articular tennis elbow, 36 patients had intraarticular tennis elbow, and 16 patients had mixed type tennis elbow. Forty-five patients were randomly assigned to treatment with percutaneous release by acupotomy according to their classified condition, and 45 patients were randomly assigned to treatment with steroid injection alone. The visual analogue scale (VAS), a tenderness assessment, a grip assessment, and the Nirschl staging system were used for outcome evaluation at pretreatment and the posttreatment timepoints at 1, 6, 12, 24 and 48 weeks. Results During the first weeks, there were no differences observed between the groups. By 6, 24 and 48 weeks, significant differences were observed between the two groups. The acupotomy group scored significantly better in nearly all outcome measures than the corticosteroid group. Conclusions For patients with lateral epicondylitis, acupotomy is just as effective as corticosteroid injections in the short term (< 6 weeks). In the long term, acupotomy has greater efficacy and is associated with a lower rate of recurrence than corticosteroid injections in the management of lateral epicondylitis.

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Which injections are effective for lateral epicondylitis?

Cited by 4 publications

References 9 publications

Comparison of the effects of neural therapy injection and extracorporeal shock wave therapy on pain and hand functions in the treatment of lateral epicondylitis

Comparison of the effects of neural therapy injection and extracorporeal shock wave therapy on pain and hand functions in the treatment of lateral epicondylitis

Comparison between acupotomy and corticosteroid injection for patients diagnosed with different classifications of tennis elbow: a randomized control trial

Effects of a minimally invasive technique for patients diagnosed with different classifications of tennis elbow: A randomized control trial

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