Lateral Epicondylitis Clinical Trial
Official title:
Corticosteroid and Lidocain Injections for Tennis Elbow
The investigators hypothesized that lidocain injection is as effective as corticosteroid injection in management of tennis elbow, and if so, it may replace corticosteroid injection in the management of tennis elbow.
Lateral epicondylitis or tennis elbow is a tendinopathy of the common extensor origin of the
lateral elbow, and is estimated to have an annual incidence of 1-3%. It is characterized by
tenderness over the lateral epicondyle of the humerus, normal range of motion, and pain on
resisted extension of the wrist or fingers. Symptoms can persist for between 6 months and 2
years but usually resolve within 12 months. Although tennis elbow is often self-limited,
around 20% of cases are refractory to conservative care. Tennis elbow is now thought to be
non-inflammatory, and the pathologies are characterized by collagen degeneration, fibroblast
proliferation, mucoid degeneration, and neovascularization.
Treatment of tennis elbow includes relative rest, physical therapy (therapeutic exercise,
massage, therapeutic ultrasound, lower power laser, etc.), analgesics, non-steroidal
anti-inflammatory drugs, glyceryl trinitrate patches, injection therapy (corticosteroid,
hyaluronan gel, botulinum toxin, and autologous platelet-rich plasma), shock wave therapy,
and even surgery. Previous studies showed corticosteroid injection is effective in the short
term, but is harmful in the long-term, and is more likely to have a recurrence. In
consideration of a degenerative lesion in tennis elbow, corticosteroid injection may be not
an ideal agent. Although plate-rich plasma injection showed promising results, the high cost
limited its widespread clinical use. Since local lidocain injection is commonly used in the
management of myofascial pain syndrome, it might be effective in the treatment of
tendinopathy like tennis elbow. The purpose of this study is to compare the effect of
corticosteroid injection and lidocain injection in the treatment of tennis elbow. The
investigators hypothesized that lidocain injection is as effective as corticosteroid
injection in management of tennis elbow, and if so, it may replace corticosteroid injection
in the management of tennis elbow.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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