• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

[Researcher Comment] Corticosteroid injections for tennis elbow associated with poorer recovery versus placebo

bys25qthea
February 5, 2013
in Chronic Disease
Reading Time: 4 mins read
0
Share on FacebookShare on Twitter

Feb 5th – JAMA – Patients receiving corticosteroid injections for tennis elbow fare worse than placebo at one year. 

[tabs tab1=”2MM Rundown” tab2= “2MM Full Report”]

[tab]

Image: PD

1. Patients receiving corticosteroid injections for tennis elbow fare worse than placebo at one year.

2. Physiotherapy made no difference in one-year recovery from tennis elbow.

RELATED REPORTS

Verona’s Ohtuvayre shows promise in the treatment and management of Chronic Obstructive Pulmonary Disease

High-dose corticosteroids increase morbidity and mortality among hypoxic COVID-19 patients

Rocatinlimab may be effective in the treatment of moderate-to-severe atopic dermatitis

This study shows that corticosteroid injections are associated with worse outcomes for patients suffering from lateral epicondylalgia (“tennis elbow”). Furthermore, physiotherapy did not ameliorate long-term symptomatology. Routine clinical usage of corticosteroid injection with concomitant active rehabilitation for lateral epicondylalgia is therefore not supported by this study.

This well-powered study nicely invokes a mechanism for the effect by highlighting features of this overuse tendinopathy. Epicondylalgia is characterized by microtrauma-induced changes in the mechanical properties of the tendon. It therefore calls for an emphasis on adequate healing in the long run. While chronic inflammation may be a very minor component of the pathophysiology of this bothersome condition, it seems that attempting to dampen cellular processes with long-term steroid injections may also hamper natural healing mechanisms—a well-known side effect of corticosteroids.

Although physiotherapy did not show to be beneficial long-term, the authors are careful not to dismiss physiotherapy for there is a notable short-term benefit. Future studies to examine the most effective interval and duration of acute physiotherapy may be informative.

Click to read the study in JAMA

[/tab]

[tab]

Image: PD

1. Patients receiving corticosteroid injections for tennis elbow fare worse than placebo at one year.

2. Physiotherapy made no difference in one-year recovery from tennis elbow.

Professor Dr. Bill Vicenzino, MSc, PhD, talks to 2 Minute Medicine: Chair in Sports Physiotherapy at the University of Queensland’s School of Health and Rehabilitation Sciences

headshot“Prior to our current study we knew that corticosteroid injections for tennis elbow produce a characteristic effect: high success rates early within 6-8 weeks but with high recurrence rates and protracted recovery there afterwards. One of the often recommended solutions to the problem of high recurrence rates and protracted recovery is to add physiotherapy to the injection. In our study, we evaluated the effect of combining injection and physiotherapy and found that (a) adding physiotherapy to corticosteroid injection does not solve the problem, (b) the corticosteroid medication appears to be responsible for the recurrence and delayed recovery (as it was much less in the placebo injection), (c) the effect of physiotherapy is compromised when combined with steroid injection, and (d) those undertaking physiotherapy take significantly less analgesic or anti-inflammatory medication (half as much).”

This [randomized controlled] study of 165 adults from 2008-2010 with at least 6 weeks of unilateral lateral epicondylalgia consisted of 4 blinded treatment groups: [1] saline injection (placebo), [2] corticosteroid injection, [3] placebo plus physiotherapy and [4] corticosteroid plus physiotherapy. For primary outcome assessment, patients reported their overall symptomatic improvement on a 6-point Likert scale. Other survey instruments were used at various intervals for secondary outcomes.

At 1 year, 90% of all patients reported complete recovery or much improvement, which previous studies have described as the natural history of the disease. At 1 year, the corticosteroid injection group demonstrated lower complete recovery compared to placebo (83% vs. 96%, p<.01) while also resulting in a higher number of recurrences (54 percent vs. 12 percent, P<.001 respectively).The physiotherapy groups showed no difference from those not receiving physiotherapy at 1 year.

In sum: This study shows that corticosteroid injections are associated with worse outcomes for patients suffering from lateral epicondylalgia (“tennis elbow”). Furthermore, physiotherapy did not ameliorate long-term symptomatology. Routine clinical usage of corticosteroid injection with concomitant active rehabilitation for lateral epicondylalgia is therefore not supported by this study.

This well-powered study nicely invokes a mechanism for the effect by highlighting features of this overuse tendinopathy. Epicondylalgia is characterized by microtrauma-induced changes in the mechanical properties of the tendon. It therefore calls for an emphasis on adequate healing in the long run. While chronic inflammation may be a very minor component of the pathophysiology of this bothersome condition, it seems that attempting to dampen cellular processes with long-term steroid injections may also hamper natural healing mechanisms—a well-known side effect of corticosteroids.

Although physiotherapy did not show to be beneficial long-term, the authors are careful not to dismiss physiotherapy for there is a notable short-term benefit. Future studies to examine the most effective interval and duration of acute physiotherapy may be informative.

Click to read the study in JAMA

By Mike Hoaglin and Rif Rahman

More from this author: Glucose but not fructose reduces cerebral blood flow in appetite and reward centers of brain, Sustained etanercept with methotrexate is effective for achieving low disease activity in moderate rheumatoid arthritis patients

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain.

[/tab]

[/tabs]

Tags: corticosteroidstennis elbow
Previous Post

Health information technology improves obesity treatment access and screening, but not patient outcomes

Next Post

More patients utilizing hospice services and choosing to die at home over past decade

RelatedReports

2 Minute Medicine Rewind May 20, 2019
Pharma

Verona’s Ohtuvayre shows promise in the treatment and management of Chronic Obstructive Pulmonary Disease

January 20, 2025
Novel coronavirus identified from patients with pneumonia in Wuhan, China
Infectious Disease

High-dose corticosteroids increase morbidity and mortality among hypoxic COVID-19 patients

May 17, 2023
Topical pimecrolimus use for atopic dermatitis not linked to malignancy
Chronic Disease

Rocatinlimab may be effective in the treatment of moderate-to-severe atopic dermatitis

January 31, 2023
Decline in adolescent sleep duration over past 20 years
Wellness

Wellness Check: Sleep

January 19, 2023
Next Post

More patients utilizing hospice services and choosing to die at home over past decade

Ramipril increases pain-free walking time in patients with peripheral artery disease

Rivaroxaban has no net clinical benefit over enoxaparin for thromboprophylaxis in acutely ill patients

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Epic Launchpad propels generative-AI into everyday hospital routines
  • #VisualAbstract: Routine Cerebral Embolic Protection Did Not Reduce Stroke Incidence during Transcatheter Aortic-Valve Implantation
  • Sodium-glucose cotransporter 2 inhibitors may decrease risk of serious liver events in patients with cirrhosis
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.