Volume : IX, Issue : I, January - 2019

Conservative management vs triamcinolone injection for tennis elbow

Dr. Melanie Philomena Valerie Gomes

Abstract :

Background and objective: Lateral epicondylitis although named as tennis elbow is seen more commonly in non–athletes than athletes. Non–operative methods are the mainstay of treatment being effective in more than 95% of cases. Corticosteroid injection has shown promise in many studies as compared to steroid injection & other modes of conservative treatment. However, evidence on their combined efficacy is lacking. This study was done to evaluate the efficacy of conservative treatment and corticosteroid injection in Lateral epicondylitis Objective To investigate the effectiveness of corticosteroid injection, versus conservative treatment in patients with unilateral lateral epicondylalgia. Materials and methods: Randomized observational study was conducted at Father Muller Medical College hospital, on a total of 100 patients aged 18 years or older with unilateral lateral epicondylalgia of longer than 6 weeks duration, who presented in the out–patient department between December 2016 and November 2017. 1–year follow–up was completed in November 2018. One group received corticosteroid injection (n = 50) and the other group recieved physiotherapy (n = 50). Measures: The outcomes were assessed by 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 (P < .01). Results: Corticosteroid injection resulted in lower complete recovery or much improvement at 1 year (78%; relative risk [RR], 0.85 [99% CI, 0.75–0.99]; P = .01) and greater 1–year recurrence (68%; RR, 0.43 [99% CI, 0.10–0.51]; P < .001). The physiotherapy did not differ on 1–year ratings of complete recovery or much improvement (88% vs 76%, respectively; RR, 1.04 [99% CI, 0.90–1.19]; P = .56) or recurrence (12%; RR, 1.31 [99% CI, 0.73–2.35]; P = .25). Similar patterns were found at 24 weeks, with lower complete recovery or much improvement after corticosteroid injection (55%; RR, 0.79 [99% CI, 0.62–0.99]; P < .001) and no difference after physiotherapy (61%; RR, 1.22 [99% CI, 0.97–1.53]; P = .84). At 4 weeks, there was a significant interaction between corticosteroid injection and physiotherapy (P = .01), whereby patients receiving physiotherapy had greater complete recovery. Conclusion Among patients with chronic unilateral lateral epicondylalgia, the use of corticosteroid injection shows only temporary improvement which after 1 year becomes worse in terms of clinical outcomes as compared to physiotherapy, where the improvement persist for a longer duration.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

CONSERVATIVE MANAGEMENT VS TRIAMCINOLONE INJECTION FOR TENNIS ELBOW, Dr. Melanie Philomena Valerie Gomes INDIAN JOURNAL OF APPLIED RESEARCH : Volume-9 | Issue-1 | January-2019

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