Objective: To analyze whether a corticosteroid injection in combination wit
h rehabilitation early in the course of lateral epicondylitis (LE) alters t
he outcome up to 6 months after injection compared with a control injection
and rehabilitation.
Design: Randomized, controlled, double-blind study.
Setting: Sports medicine center in a tertiary care center.
Participants: Subjects with a diagnosis of LE whose symptoms had been prese
nt less than 4 weeks were included. Subjects were recruited by word of mout
h and through advertising. The 39 subjects who were recruited were 18 to 65
years old.
Interventions: 19 subjects were randomized to receive rehabilitation and a
sham injection, and 20 were randomized to receive rehabilitation and a cort
icosteroid injection. At 4 and 8 weeks, they were reevaluated and their tre
atment programs were modified, if indicated.
Main Outcome Measures: Outcome measurements were performed at baseline, 4 w
eeks, 8 weeks, and 6 months, and included a functional pain questionnaire a
nd a visual analogue pain scale. Painless grip strength on the affected sid
e and maximal grip strength bilaterally were measured at baseline, 4 weeks,
and 8 weeks.
Results: There were no significant differences in outcome between the two g
roups with the exception of an improvement in the visual analogue pain scal
e in the corticosteroid group from 8 weeks to 6 months. Outcome measurement
s in both groups improved significantly over time; more than 80% of subject
s reported improvements from baseline to 6 months for all scales.
Conclusion: A corticosteroid injection does not provide a clinically signif
icant improvement in the outcome of LE, and rehabilitation should be the fi
rst line of treatment in patients with a short duration of symptoms.