Comparision Two Therapeutic Methods for Lateral Epicondylitis: A Double-Blind Clinical Trial

Document Type : Original Article(s)

Authors

1 Associate Professor of Orthopaedicsurgery ,hand surgery, Department of Orthopaedic, School of Medicine, Isfahan University of Medical Sciences, Isfahan

2 Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan

3 Assistant Professor of Orthopaedicsurgery, Department of Orthopaedic, School of Medicine, Isfahan University of Medical Sciences, Isfahan

Abstract

  Background:One of the mostly used several methods introduced for treatment of lateral epicondylitisthis condition which is mostly used is local steroid injection. Flexing the wrist of involved hand strongly and suddenly, which is called ";;complete the lesion";; is of methods used with local steroid injection and is not truly known. During a six-month study, we compared the effects of local steroid injection with and without ";;complete the lesion";; maneuver. Methods:Through a double-blind clinical trial, 50 patients with lateral epicondylitis, visiting the orthopedic clinic of Ayatollah Kashani Hospital, Isfahan, were studied in two groups of 25. Case group received local steroid injection with ";;complete the lesion";; maneuver and their hands were casted with a long plaster for 3 weeks. The control group received all above actions, except for ";;complete the lesion";; maneuver. The patients were evaluated based on Verhaar criteria in third, sixth, twelfth, and twenty fourth weeks and categorized in four groups of excellent, good, intermediate, and poor. During the follow up period, seven patients were excluded from the study. Data were analyzed with Friedman and Man-Whitney analytical tests. Findings:During the follow up period, totally, there was no significant difference between case and control groups (Man-Whitney test, P > 0.05). During the third week evaluation, the median of case group scores was a little higher than the control group ones (3.02 vs. 2.77). Also, we found that the treatments used for both groups had analytically significant effects (Friedman test, P < 0.05). Conclusion:During the six-month follow up, we didn't find any significant difference between the effects of local steroid injection with or without ";;complete the lesion";; maneuver. Patients in case group had more pain, rather than in control group, through the first three weeks. Treatments used for both groups showed acceptable results through the short-term (weeks 3 and 6) and long-term (weeks 12 and 24) evaluations. It seems that more studies in longer time periods, focusing on the factors affecting condition relapse, may be useful.   Key words: Lateral epicondylitis, Tennis elbow, Local steroid injection, Clinical trial, Wrist flexion.