Featured Research

from universities, journals, and other organizations

Corticosteroid injection, physiotherapy do not provide significant improvement for 'tennis elbow'

Date:
February 5, 2013
Source:
American Medical Association (AMA)
Summary:
Among patients with chronic unilateral lateral epicondylalgia ("tennis elbow"), a single injection of corticosteroid medication was associated with poorer outcomes after one year and higher recurrence rates compared with placebo, while eight weeks of physiotherapy did not significantly improve long-term outcomes, according to a new study.

Among patients with chronic unilateral lateral epicondylalgia ("tennis elbow"), a single injection of corticosteroid medication was associated with poorer outcomes after one year and higher recurrence rates compared with placebo, while eight weeks of physiotherapy did not significantly improve long-term outcomes, according to a study appearing in the February 6 issue of JAMA.

Related Articles


"Use of corticosteroid injections to treat lateral epicondylalgia is increasingly discouraged, partly because evidence of long-term efficacy has not been found, and due to high recurrence rates," according to background information in the article. Combining corticosteroid injection with physiotherapy to compensate for the poor long-term outcomes of corticosteroid injections has been evaluated in only 2 small studies, and the long-term effects of combining these therapies are not known.

Brooke K. Coombes, Ph.D., of the University of Queensland, St. Lucia, Australia, and colleagues conducted a study to evaluate the effectiveness of corticosteroid injection, multimodal physiotherapy, or both in 165 patients with unilateral lateral epicondylalgia of longer than 6 weeks' duration. The patients were enrolled between July 2008 and May 2010; 1-year follow-up was completed in May 2011. Patients were randomized to either corticosteroid injection (n = 43), placebo injection (n = 41), corticosteroid injection plus physiotherapy (n = 40), or placebo injection plus physiotherapy (n = 41). The 2 primary outcomes were 1-year global rating of change scores for complete recovery or much improvement and 1-year recurrence (defined as complete recovery or much improvement at 4 or 8 weeks, but not later) analyzed on an intention-to-treat basis. Secondary outcomes included complete recovery or much improvement at 4 and 26 weeks.

The researchers found that corticosteroid injection demonstrated lower complete recovery or much improvement at 1 year compared with placebo injection (83 percent vs. 96 percent) and greater recurrence (54 percent vs. 12 percent). There were no differences between physiotherapy and no physiotherapy at 1 year for complete recovery or much improvement (91 percent vs. 88 percent) or recurrence (29 percent vs. 38 percent).

There were no significant interaction effects at 26 weeks. The corticosteroid injection demonstrated lower complete recovery or much improvement compared with the placebo injection (55 percent vs. 85 percent). Physiotherapy compared with no physiotherapy demonstrated no effects on the outcomes of complete recovery or much improvement (71 percent vs. 69 percent), and with no significant differences on measures of worst pain; resting pain; pain and disability; and quality of life.

"At 4 weeks, there was a significant interaction between corticosteroid injection and physiotherapy, whereby patients receiving the placebo injection plus physiotherapy had greater complete recovery or much improvement vs. no physiotherapy (39 percent vs. 10 percent, respectively). However, there was no difference between patients receiving the corticosteroid injection plus physiotherapy vs. corticosteroid alone (68 percent vs. 71 percent, respectively)," the authors write.

"Contrary to our hypothesis and to a generally held clinical view, we found that multimodal physiotherapy provided no beneficial long-term effect on complete recovery or much improvement, recurrence, pain, disability, or quality of life, thereby not supporting the hypothesis that the combined approach is superior. However, physiotherapy should not be dismissed altogether because in the absence of the corticosteroid, it provided short-term benefit across all outcomes, as well as the lowest recurrence rates (4.9 percent) and 100 percent complete recovery or much improvement at 1 year."


Story Source:

The above story is based on materials provided by American Medical Association (AMA). Note: Materials may be edited for content and length.


Journal Reference:

  1. Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B. Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia: A Randomized Controlled Trial. JAMA, 2013; 309 (5): 461-469 DOI: 10.1001/jama.2013.129

Cite This Page:

American Medical Association (AMA). "Corticosteroid injection, physiotherapy do not provide significant improvement for 'tennis elbow'." ScienceDaily. ScienceDaily, 5 February 2013. <www.sciencedaily.com/releases/2013/02/130205162119.htm>.
American Medical Association (AMA). (2013, February 5). Corticosteroid injection, physiotherapy do not provide significant improvement for 'tennis elbow'. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2013/02/130205162119.htm
American Medical Association (AMA). "Corticosteroid injection, physiotherapy do not provide significant improvement for 'tennis elbow'." ScienceDaily. www.sciencedaily.com/releases/2013/02/130205162119.htm (accessed November 27, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) — The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com
Experimental Ebola Vaccine Shows Promise In Human Trial

Experimental Ebola Vaccine Shows Promise In Human Trial

Newsy (Nov. 27, 2014) — A recent test of a prototype Ebola vaccine generated an immune response to the disease in subjects. Video provided by Newsy
Powered by NewsLook.com
Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) — Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) — Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins