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Steroid Injections not a Good Treatment Option for Tennis Elbow: Study

Update Date: Feb 06, 2013 04:31 AM EST

Commonly used corticosteroid shot for tennis elbow may not be as effective as considered, a new study from Australia has shown.

Tennis elbow is a painful condition that is caused by tears in tendon due to overuse of the hands and wrists. The condition causes severe pain on the "outside (lateral) side of the upper arm near the elbow," says PubMed Health.

Corticosteroid shots are given to relieve pain and inflammation in joints of the ankle, elbow, knee, hips and wrist, according to Mayo Clinic. Apart from tennis elbow, these shots are also helpful in relieving pain associated with frozen shoulders, osteoarthritis and rheumatoid arthritis. These injections carry the potential risks of joint infection, nerve damage, thinning of nearby bone and tendon rupture, among others.

The latest study from University of Queensland in Australia has now found that although these steroid injections may give short-term relief, their effects weakens in the long run. In fact, using these injections slowed a patient's recovery from other techniques like physiotherapy.

"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 Bill Vicenzino, chairman of sports physiotherapy at the University of Queensland in St. Lucia, Australia, and senior author of the study, reports HealthDay.

Back in 2010, Vicenzino and colleagues had shown that cortisone injections actually prolong the condition. He had then advised that doctors should consider recommending other forms of therapies for the condition to their patients. The previous study, published in the journal Lancet, found that there was a 64 percent increased risk of the condition affecting the patients again, when compared to physiotherapy program that helps the patients gain movement through exercises.

Another commentary by Vicenzino and colleagues published in the Journal of Manual and Manipulative Therapy in 2007 had shown that increasing movement through controlled exercises may be effective in treating tennis elbow.  

The present study included some 165 adults. All participants were suffering from tennis elbow and were assigned to receive one of the four treatments of steroid shots either with or without physiotherapy and non-steroidal shots with or without physical therapy. The rates of recovery from tennis elbow after a year of therapy were 83 percent for people who received cortisone shots, compared to 96 percent for those in the placebo group, Reuters Health reported. Typically, an injection of cortisone starts at $100.

"Among patients with chronic unilateral lateral epicondylalgia, the use of corticosteroid injection vs placebo injection resulted in worse clinical outcomes after 1 year, and physiotherapy did not result in any significant differences," the researchers concluded.

The present study is published in the Journal of the American Medical Association.        

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