A randomized controlled clinical trial evaluating the role of intra-lesional steroids in the management of tennis elbow

Abstract

Although intra-lesional steroids are widely used in the management of tennis elbow, some recent reports have doubted their usefulness. A prospective double-blinded randomized controlled clinical trial was conducted to evaluate the usefulness of intra-lesional steroid injections in tennis elbow. The study included 78 cases with a mean age of 39.8 years, who were divided into two randomized groups A (experimental) and B (control). Group A received one intra-lesional injection of 10mg triamcinolone acetate(40 mg/ml) mixed with 0.75 ml of 2% plain lignocaine using peppering injection technique, followed by stretching exercises, whereas group B received only stretching exercises. Follow-up was done for 4 months using fortnightly patient-rated tennis elbow evaluation score (PRTEE). Statistical analysis was done using Student t-test. Average PRTEE score in group A and B at beginning were 78 and 80, respectively. After 4 months, average PRTEE score in group A was 24 and in group B was 25 (p value=0.97, insignificant). Nearly 74% group A patients reported mild to severe intensity pain in immediate post-injection period, which subsided in few days with or without medication. It was concluded that the use of intra-lesional injections does not seem to significantly affect the outcome in tennis elbow.