LOCAL CORTICOSTEROID INJECTION VERSUS CYRIAX-TYPE PHYSIOTHERAPY FOR TENNIS ELBOW

We performed a prospective, randomised trial on 106 patients to compar e the effects of local corticosteroid injections with physiotherapy as advocated by Cyriax in the treatment of tennis elbow The main outcome measures were the severity of pain, pain provoked by resisted dorsifl exion of the wrist, and patient satisfaction. At six weeks 22 of 53 pa tients in the injection group were free from pain compared with only t hree in the physiotherapy group, In the corticosteroid-treated group 2 6 patients had no pain on resisted dorsiflexion of the wrist compared with only three in the physiotherapy group, Thirty-five patients who h ad injections and 14 who had physiotherapy were satisfied with tbe out come of treatment at six weeks. At the final assessment there were 18 excellent and 18 good results in the corticosteroid group and one exce llent and 12 good results in the physiotherapy group, There was a sign ificant increase in grip strength in both groups but those with inject ions had a significantly better result, After one year there were no s ignificant differences between the two groups, Half of the patients, h owever, had received only the initial treatment, 20% had had combined therapy and 30% had had surgery. We conclude that at six weeks, treatm ent with corticosteroid injections was more effective than Cyriax phys iotherapy and we recommend it because of its rapid action, reduction o f pain and absence of side-effects.