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Botulinum injection provides relief of tennis elbow

Date:
April 27, 2010
Source:
Canadian Medical Association Journal
Summary:
An injection of botulinum toxin can provide relief for "tennis elbow" but needs to be injected properly to avoid potential paralysis, states a research article.

An injection of botulinum toxin can provide relief for "tennis elbow" but needs to be injected properly to avoid potential paralysis, states a research article in CMAJ (Canadian Medical Association Journal).

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The study, a randomized controlled trial of 48 patients, was performed at Imam Khomeini Hospital Complex, affiliated with the Tehran University of Medical Sciences that serves patients from all over Iran. It was conducted to introduce an easy and effective method for injection of botulinum toxin to be used in routine practice. Instead of a fixed injection site physicians determined the injection site based on each patient's forearm length. All participants' used in the study had undergone previous therapeutic interventions that failed.

It is very important when paralyzing a muscle to know the appropriate injection site. Injection at a fixed distance from anatomic landmarks, as was performed in previous clinical trials of botulinum toxin for the management of lateral epiconylitis (tennis elbow), could result in inadequate paralysis.

"We found that pain at rest and pain during maximum pinch were significantly reduced in patients with lateral epicondylitis [tennis elbow] after botulinum toxin was injected at the site based on precise anatomic measurement of each patient's forearm length," write Dr. Mortazavi, Iman Khomeini Hospital, Tehran University of Medical Sciences, Iran, and coauthors. "However, this method caused a decline in maximum strength and resulted in extensor lag."

The authors conclude that precise measurement to guide injection of botulinum toxin can be effective in the management of chronic "tennis elbow." However, it should be used for patients whose job does not require finger extension. Further research is needed to determine whether the pain-relieving effects of the treatment remain or diminish after four months.

In a related commentary, Dr. Rachelle Buchbinder of Monash University, Australia, writes that the high costs to an individual and society related to sick leave and disability from lateral epicondylitis mean there is a clear need to identify the most cost-effective therapies. However, botulinum toxin, although shown to reduce pain, may not be the right therapy for everyone because its effect on function, quality of life and pain-free grip is unknown. Also, it can cause partial loss of movement of the third and fourth fingers which may be unacceptable for some people.


Story Source:

The above story is based on materials provided by Canadian Medical Association Journal. Note: Materials may be edited for content and length.


Journal Reference:

  1. Ramin Espandar, Pedram Heidari, Mohammad Reza Rasouli, Soheil Saadat, Mahmood Farzan, Mohsen Rostami, Shideh Yazdanian, and Javad Mortazavi. Use of anatomic measurement to guide injection of botulinum toxin for the management of chronic lateral epicondylitis: a randomized controlled trial. CMAJ, 2010; DOI: 10.1503/cmaj.090906

Cite This Page:

Canadian Medical Association Journal. "Botulinum injection provides relief of tennis elbow." ScienceDaily. ScienceDaily, 27 April 2010. <www.sciencedaily.com/releases/2010/04/100426131419.htm>.
Canadian Medical Association Journal. (2010, April 27). Botulinum injection provides relief of tennis elbow. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2010/04/100426131419.htm
Canadian Medical Association Journal. "Botulinum injection provides relief of tennis elbow." ScienceDaily. www.sciencedaily.com/releases/2010/04/100426131419.htm (accessed November 27, 2014).

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