TENNIS ELBOW: ROLE OF LOCAL STEROID INJECTION
Abstract
Background: Tennis elbow is a condition, characterised by pain and tenderness over the lateralepicondyle of the humerus, and pain on resisted dorsiflexion of the wrist, middle finger, or both. Theaim of this randomised controlled trial was to investigate the short term efficacy of local steroidinjection compared with oral and topical NSAIDs. Methods: Sixty patients (45 male and 15 female)were included in the study. The mean age was 42 years for men and 40 years for women. They wereplaced in group A and B (30 cases each). Group A received local steroid injection (triamcinolone 20mg mixed with lignocaine 2% 1 cc) and topical NSAID cream application (diclofenacdiethylammonium) twice a day, tab. diclofenac sodium 50 mg twice a day for 3 weeks. Group Breceived tab diclofenac 50 mg twice a day and, topical NSAID cream application twice a day for 3weeks. Assessment of patients was made 3 times; first at the start of the study, 2nd time after 6 weeks,and 3rd time after 12 weeks. A blinded assessor rated the elbow complaints of the patients at resisteddorsiflexion of wrist using VAS (0=no severity, 1–3 mild, 4–6 moderate, 7–9 sever, 10=maximumseverity). Results: At six weeks, 22 (73.33%) patient in group A had no pain as compared to 7(23.33%) patients in group B who were pain free (p<0.0001, χ2=38.75). At 12 weeks 27 (90%) patientsin group A were pain free compared to group B in which 7 (23.33%) patients were pain free (p<0.0001,2χ=27.56). Conclusion: In patients with tennis elbow, the use of local steroid injection in combinationwith topical and oral NSAIDs is superior to the use of combination of topical and oral NSAIDs. Betterresults with combination therapy using local steroid injection may be limited to the short term.Keywords: Tennis elbow, steroid, painReferences
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