Comparative study of local corticosteroid injection and therapeutic ultrasound with exercise for quicker functional improvement in tennis elbow

Abstract

Introduction: Tennis elbow is also known as Lateral epicondylitis which is an over use injury to the area of the lateral epicondyle of the elbow end of the humerus. It is generally attributed to osteotendinous irritation of the common extensor origins of Extensor Carpi Radialis. Local infiltration with 1ml tramicinolone acetate (10mg/ml) and 1ml 2% lidocaine is most commonly used for therapeutic relief of this condition. Therapeutic Ultrasound is another modality used in the treatment for functional relief of tennis elbow. Therapeutic ultrasound, a deep heater agent is effective with vibration but primarily through heat in lateral epicondylitis. With its thermal and mechanical effects, it increases local metabolism, blood flow, soft tissue flexibility and regeneration and membrane permeability and changes nerve conduction. It reduces pain and increases joint movement opening. Comparative study between Local steroid injections and Therapeutic ultrasound for the quicker functional relief of tennis elbow or lateral epicondylitis was the basis of this study. Materials and Methods: The present study of 100 cases was conducted in the Department of Orthopedics at Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune. The results were evaluated for comparison between injection corticosteroids, therapeutic ultrasound and exercise rehabilitation in the functional relief of tennis elbow. Follow-up was done at 10 days, 6 weeks and 6 months. Patient outcome was assessed on their respective follow-up. The Measure of strength through Pain Free Grip and PRTEE which assessed the pain and functional disability of the patient in a standardised way were used as parameters.Conclusion: In conclusion, the results from our study showed that all three treatment groups were effective showing improvement over time at different intervals of time for different aspects of the clinical picture. The result for injection therapy in our study was that corticosteroid injection has superior effectiveness in the short term when compared with exercise therapy and therapeutic ultrasound. Similarly, in the long term, results of our study supported that exercise was the most effective followed by therapeutic ultrasound and that the effectiveness of exercise and ultrasound in comparison to injection therapy was higher in the long term with injection corticosteroid therapy being the least effective.