The effect of corticosteroid, and saline injection on pain perception and function of patients with lateral epicondylitis: A triple-blinded, randomized, controlled trial
Main Article Content
Keywords
External epicondylitis, corticosteroid, normal saline
Abstract
Introduction: Lateral epicondylitis is usually associated with chronic disability and no suitable treatment is available for it. Investigating effective treatment methods for this disease is essential. We compared saline, corticosteroid for lateral epicondylitis in a triple-blinded, randomized, controlled trial.
Materials and methods: Patients with clinically diagnosed lateral epicondylitis of less than 3 months' duration were included in the study. First, demographic information was completed for each patient. Then the patients were asked to rate their pain level based on the VAS scale and the DASH performance questionnaire was also completed for each person. Then, the first group was treated with triamcinolone and the second group was treated with normal saline injection. Patients underwent clinical evaluation before and after one month and after three months of treatment.
Results: Our findings demonstrated that both corticosteroid injection and normal saline treatment were capable of improving the pain and function of the patients in terms of the DASH questionnaire in the short term, but similar to normal saline, symptoms returned in the long term (after 3 months), where the pain score increased between 0.5 and 1 units and the DASH score increased between 5 and 10 units.
Conclusion: Corticosteroid injection was not found to be superior to saline, when both methods were ineffective in terms of long-term effects, while they were more effective in the short term.
References
2. Alizadeh R, Sharifzadeh S R. Pathogenesis, etiology and treatment of failed back surgery syndrome. Neurochirurgie. 2022;68(4):426-431.
3. Lebiedziński R, Synder M, Buchcic P, Polguj M, Grzegorzewski A, Sibiński M. A randomized study of autologous conditioned plasma and steroid injections in the treatment of lateral epicondylitis. Int Orthop. 2015 Nov. 39 (11):2199-203.
4. Faro F, Wolf JM. Lateral epicondylitis: review and current concepts. Journal of hand surgery. 2007;32(8):1271–9
5. Herquelot E, Guéguen A, Roquelaure Y, Bodin J, Sérazin C, Ha C, et al. Work-related risk factors for incidence of lateral epicondylitis in a large working population. Scand J Work Environ Health. 2013 Nov. 39(6):578-88.
6. Kaeding C, Best TM. Tendinosis pathophysiology and nonoperative treatment. Sports Health. 2009; 1(4):284–92.
7. Andres BM, Murrell GA. Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clinical orthopaedics and related research. 2008;466(7):1539–54
8. Sharifzadeh SR, Shahrezaee M, Okhovatpour MA, Asadi Boroujeni S, Banasiri M. Comparison of the effectiveness of femoral fixation techniques (Aperfix and Endobutton) in anterior cruciate ligament surgery: A clinical trial in men with complete anterior cruciate ligament rupture. AMJ 2017;10(9):816–820.
9. Ozturan KE, Yucel I, Cakici H, Guven M, Sungur I. Autologous blood and corticosteroid injection and extracoporeal shock wave therapy in the treatment of lateral epicondylitis. Orthopedics. 2010;33(2)
10. Shakouri S K, Eftekhar-Sadat B, Johari F, Ghojazadeh M, Hemmati S, Ghaffari G. To Compare the Effect of Ultrasound Guided Local Injection of Dexamethasone with Dexamethasone Phonophoresis for Treatment of Lateral Epicondylitis (Tennis Elbow). J Arak Uni Med Sci. 2015; 18 (9) :57-65
11. ozturan KE, yucell, cakici H, Guvern M, sunger I Autologons blood and corticosteroid injection and extracorporeal shock wave therapy in the treatment of lateral epicodylitis orthopedis. 2010 Feb. 33(2): 34-21
12. lebiedziniki R.synder M, Buchcic p, polguj, sibinsik M A Randomized study of autologons conditional plasma and steroid injections in the treatment of lateral epycondylitis in orthop. 2015 Nov. 39 (11): 2199.203.
13. Nilsson P, Baigi A, Swärd L, Möller M, Månsson J. Lateral epicondylalgia: a structured programme better than corticosteroids and NSAID. Scand J Occup Ther. 2012 Sep. 19(5):404-10.
14. Bisset L, et al. Mobilization with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomized trial. BMJ. Nov 4 2006; 333(7575):939.
15. Mousavi SJ, Parnianpour M, Abedi M, Askary-Ashtiani A, Karimi A, Khorsandi A, Mehdian H. Cultural adaptation and validation of the Persian version of the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Clin Rehabil. 2008 Aug; 22(8):749-57
16. Murtezani A, et al. Exercise and therapeutic ultrasound compared with corticosteroid injection for chronic lateral epicondylitis: A randomized controlled trial. Otop Traumatol Rehabil 2015
17. Wolf JM, Ozer K, Scott F, Gordon MJ, Williams AE. Comparison of autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: a prospective, randomized, controlled multicenter study. J Hand Surg Am. 2011 Aug. 36(8):1269-72.
18. Krogh TP, Fredberg U, Stengaard-Pedersen K, Christensen R, Jensen P, Ellingsen T. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: A randomized, double-blind, placebo-controlled trial. Am J Sports Med. 2013;41:625–35.
19. Hart L. Corticosteroid and other injections in the management of tendinopathies: A review. Clin J Sport Med. 2011;21:540–1
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.