Navigation Links
Steroid Shots for Tennis Elbow Miss the Mark: Study

By Steven Reinberg
HealthDay Reporter

TUESDAY, Feb. 5 (HealthDay News) -- A corticosteroid shot is a common treatment for "tennis elbow," but a new study finds it might do more harm than good.

For people with tennis elbow -- a painful condition related to overuse of the tendon in the elbow -- more bad news emerged from the study: Combining physical therapy with a steroid shot was of no benefit over the long-term either.

"Patients having steroid injections should be warned of the potential for recurrence three to 12 months after the injection, even after feeling any benefit in the short term," said senior study author Bill Vicenzino, chairman of sports physiotherapy at the University of Queensland in St. Lucia, Australia.

Recurrences are usually put down to the fact that patients feel better after the injection and then do too much too soon, Vicenzino said.

To avoid this, physical therapy may be recommended post-injection to moderate the return to full activity through strengthening exercises, he explained.

"However, the steroid injection produced higher recurrence rates than did a placebo injection, indicating that the actual steroid medication is likely the reason for the high recurrence rates," not the early return to activity, Vicenzino said.

In the long term, the steroid injection was significantly less beneficial than the placebo injection, even with physical therapy, he said.

Dr. Marc Kowalsky, an orthopedic surgeon at Lenox Hill Hospital in New York City, wasn't surprised by the corticosteroid findings. "We have been skeptical for a significant amount of time about the utility of cortisone injections for tennis elbow, because it is really not an inflammatory condition, so it wouldn't make sense that a cortisone injection would work," he said.

But the finding that physical therapy was ineffective did come as a surprise, he said. "Most of us believe there is a role for physical therapy in the treatment of tennis elbow," Kowalsky said.

Although the study found physical therapy combined with injection was not particularly helpful, the authors said physical therapy alone should not be ruled out completely as it provided short-term relief, the lowest recurrence rates and much improvement or recovery after a year.

The real message of this study is that the best way to treat tennis elbow isn't known, Kowalsky said. "We really don't know how to treat these patients if they don't respond to physical therapy."

For the study, published in the Feb. 6 issue of the Journal of the American Medical Association, Vicenzino's team randomly assigned 165 patients with tennis elbow to one of four treatments: a steroid injection; a placebo injection; a steroid injection and physical therapy, or a placebo injection and physical therapy. Patients had about eight weekly therapy sessions, on average.

After a year, the investigators found that 83 percent of those who had a steroid injection had a complete recovery or were much improved, compared with 96 percent of those who had the placebo injection.

Moreover, 54 percent of those who got the steroid injection had a recurrence of tennis elbow, compared with only 12 percent of those given the placebo, the researchers said.

No significant differences in recovery or recurrence were noted between those who had physical therapy and those who didn't.

Nor was there a significant difference between patients who got the steroid shot alone compared to patients who got the injection plus physical therapy.

"Our findings did not support the commonly held view that any recurrence or delayed healing effect following corticosteroid injection can be remedied by moderating loads and a program of physiotherapy," Vicenzino said.

Another expert agrees steroid injections don't help tennis elbow. Instead, Dr. Andrew Rokito, chief of shoulder and elbow surgery at NYU Langone Medical Center in New York City, said he believes the best medicine is giving the elbow time to heal.

"We discourage patients from cortisone," Rokito said. "While it may give them a very short-term benefit, overall it doesn't help."

Tennis elbow is a repetitive activity injury, Rokito said. "The best thing for patients to do is rest from the offending activity."

More information

For more information on tennis elbow, visit the U.S. National Library of Medicine.

SOURCES: Bill Vicenzino, Ph.D., chairman, sports physiotherapy, University of Queensland, St. Lucia, Australia; Marc Kowalsky, M.D., orthopedic surgeon, Lenox Hill Hospital, New York City; Andrew Rokito, M.D., associate professor, chief, division of shoulder and elbow surgery, NYU Langone Medical Center, New York City; Feb. 6, 2013, Journal of the American Medical Association

Copyright©2012 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Do non-steroidal anti-inflammatory drugs cause kidney failure in children?
2. Botox beats steroids for painful foot condition, plantar fasciitis
3. University of Cincinnati leads first trial on steroid and CNI withdrawal post-transplant
4. Meningitis/Steroid Toll Now 34 Dead
5. Congress to Open Hearings Into Steroid/Meningitis Outbreak
6. Steroid Shots for Sciatica: Benefits Only Brief, Analysis Finds
7. Expensive arthritis treatment no better than steroid therapy
8. Report Details Start of Steroid Meningitis Outbreak
9. Steroid-Meningitis Toll Now 30 Dead, 419 Sickened, CDC Says
10. Greenish-Black Contaminant in Vials of Steroid Behind Meningitis Outbreak: FDA
11. Steroid injection linked to increased risk of bone fractures
Post Your Comments:
Related Image:
Steroid Shots for Tennis Elbow Miss the Mark: Study
(Date:11/29/2015)... St. Petersburg, FL (PRWEB) , ... November 30, 2015 , ... The Cyber Monday deal ... webstore. , It is the right time to get gifts for the skin care lover ... bow on top filled with serums . This year, the 3 serums are staples: Collagen, ...
(Date:11/29/2015)... PITTSBURGH, PA (PRWEB) , ... November 29, 2015 , ... ... assistance with kneeling or provide ready access to exercise weights. Fortunately, an inventor from ... prototype for THE TOMMY WALKER to enhance the benefits of a standard walker to ...
(Date:11/29/2015)... ... November 29, 2015 , ... Effective immediately, every single IguanaMed scrub ... on Black Friday Target is offering a “Buy One Scrub Set, Get the 2nd ... opportunity to purchase IguanaMed at a discounted price. , IguanaMed’s mission is ...
(Date:11/28/2015)... ... 28, 2015 , ... Safe storage for contraceptive devices may not always be ... New Jersey and the other from Bradley Beach, New Jersey, there is an easy ... of having to replace NuvaRings more often than necessary. As such, it affords peace ...
(Date:11/28/2015)... , ... November 28, 2015 , ... Pixel Film Studios ... media panels to choose from, the possibilities are endless. Users have full control over ... the ProPanel: Pulse masking effects, users are sure to get heads to turn. , ...
Breaking Medicine News(10 mins):
(Date:11/29/2015)... 29, 2015 CIVCO Medical Solutions will ... the Radiological Society of North America ... November 29 – December 4, 2015. ... offer customers unrivaled versatility, enhanced user experience and ... --> ...
(Date:11/27/2015)... 2015  Lannett Company, Inc. (NYSE: LCI ... acquisition of Kremers Urban Pharmaceuticals Inc. (KU), the ... company UCB S.A. (Euronext: UCB). ... KU from UCB for total consideration of approximately ... customary working capital adjustment, a deduction of certain ...
(Date:11/26/2015)... 26 november 2015 AAIPharma Services ... geplande investering aan van ten minste $15,8 ... en het mondiale hoofdkantoor in ... resulteren in extra kantoorruimte en extra capaciteit ... groeiende behoeften van de farmaceutische en biotechnologische ...
Breaking Medicine Technology: