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Steroid Injections Not a Long-Term Solution to Tennis Elbow

November 6, 2006 02:48 PM
By Jim Brown, Ph.D., Executive Editor, Sports Performance Journal, Author, Tennis: Steps to Success.

Steroid injections might provide short-term relief for tennis elbow, but don’t count on it as a long-term solution. In fact, doing nothing — if nothing includes not playing tennis — is just as effective as the steroid option.

Researchers in Australia tested different treatments on three separate groups of patients with tennis elbow. One group of participants were allocated the “wait and see” approach – they were reassured that the condition would eventually settle down and encouraged to wait. They were also given specific instructions on modifying their daily activities to avoid aggravating their pain.

A second group was given a corticosteroid injection and advised to gradually return to normal activities. The final group received eight physical therapy treatments of 30 minutes over six weeks, and the subjects were taught home exercises and self-manipulation. The physical therapy group also received a resistance exercise band and an exercise instruction booklet. Each group’s progress was measured at six weeks and again after a year.

Initially, corticosteroid injections were the most successful treatment, with 78 percent of those in the group reporting improvements, followed closely by physical therapy with a 65 percent success rate when compared to just 27 percent in the ‘wait and see’ group.

However, after 52 weeks the injection group rates of improvement were significantly worse than those of the physical therapy group. The injection group also had the most reported recurrences, with 72 percent of participants’ conditions deteriorating after three or six weeks. That result could have been due in part to a quicker initial recovery leading to greater use and stressing the elbow.

The research also found that the long-term effects of physical therapy were the same as the wait and see approach. At the end of the study participants in both the therapy and wait and see group had either greatly improved or completely recovered.

According to the authors, “The poor overall performance of corticosteroid injections should be taken under consideration by both the patient and his or her doctor in management of tennis elbow.”

The study findings also support the idea that tennis elbow is, in most cases, a self-limiting condition. “Patients with tennis elbow can be reassured that, in the majority of cases, they will improve in the long term when given information and movement advice about their condition.”

 

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