Official websites use. Share sensitive information only on official, secure websites. Lateral epicondylitis of the elbow is a frequent condition with long-lasting symptoms.
Corticosteroid injection is increasingly discouraged and there is little knowledge on the combined effect of corticosteroid injection and physiotherapy for acute conditions. We wanted to investigate the efficacy of physiotherapy alone and combined with corticosteroid injection for acute lateral epicondylitis. A randomized, controlled study with one-year follow-up was conducted in a general practice setting in Sarpsborg, Norway.
We included men and women aged 18 to 70 with clinically diagnosed lateral epicondylitis of recent onset 2 weeks to 3 months. They were randomly assigned to one of three treatments: physiotherapy with two corticosteroid injections, physiotherapy with two placebo injections or wait-and-see control.
Physiotherapy consisted of deep transverse friction massage, Mills manipulation, stretching, and eccentric exercises. We used double blind injection of corticosteroid and single blind assessments. The main outcome measure was treatment success defined as patients rating themselves completely recovered or much better on a six-point scale.
Placebo injection with physiotherapy showed no significant difference compared to control or to corticosteroid injection with physiotherapy at any follow-up. Corticosteroid injection with physiotherapy had a At 52 weeks there was no significant difference. Both control and placebo injection with physiotherapy showed a gradual increase in success. Physiotherapy with deep transverse friction massage, Mills manipulation, stretching, and eccentric exercises showed no clear benefit, and corticosteroid injection gave no added effect.
