COMPARISON OF CORTICOSTEROID INJECTION WITH THERAPEUTIC ULTRASOUND FOR PAIN MANAGEMENT IN LATERAL EPICONDYLITIS

2021 ◽  
pp. 67-68
Author(s):  
Pradip kumar Mallick ◽  
Ushnish Mukherjee
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Therapeutic Ultrasound ◽  
Lateral Epicondylitis ◽  
Local Steroid Injection ◽  
Group 2 ◽  
Group 1

Background: Lateral epicondylitis is the most common presentation of lateral elbow pain and quite disabling entity in Musculoskeletal rehabilitation. Among the various treatment options, therapeutic ultrasound and local steroid injection are commonly used for managing pain in these patients, but comparative effectiveness of these two treatment procedures are often debated. Aim of Study: To evaluate the efcacy of local corticosteroid injection versus therapeutic ultrasound regarding pain reduction in patients with Lateral epicondylitis. Method:This interventional study was conducted on 56 patients of both sexes within the age group of 18-60 years with unilateral Lateral epicondylitis. They were randomly divided in two groups of same number(28 in each group)- Group-1: managed with local injection of steroid (methylprednisolone-10mg, single dose) with 2% of 0.5 ml lignocaine and Group-2 : managed with Therapeutic Ultrasound. Improvement of pain was assessed in 0-10 visual st analogue scale(VAS). Data collected at 0 week (Visit-1 or Pre-initiation), 3weeks (Visit-2 or 1 Follow up), 6 weeks (Visit-3), 12 weeks (Visit-4). Result: For VAS(pain) score, in both Group-1 and Group-2, there was signicant decrease in subsequent visits (p<0.05). The mean VAS(pain) score of Group-1 was signicantly lower than that of Group-2 in visit -2(p<0.01), visit-3(p<0.01) & visit-4(p<0.05) indicating better outcome in Group-1. Conclusion: Both Local Steroid injection (methylprednisolone) & therapeutic ultrasound are effective in pain management of lateral epicondylitis but Local steroid injection is more effective mostly in early follow up period.

ROLE OF LOCAL CORTICOSTEROID INJECTION VS THERAPEUTIC ULTRASOUND REGARDING IMPROVEMENT IN PAIN FREE GRIP STRENGTH OF TENNIS ELBOW PATIENTS

2021 ◽  
pp. 76-77
Author(s):  
Pradip Kumar Mallick ◽  
Ushnish Mukherjee
Keyword(s):  
Grip Strength ◽  
Steroid Injection ◽  
Tennis Elbow ◽  
Corticosteroid Injection ◽  
Initial Period ◽  
Therapeutic Ultrasound ◽  
Lateral Epicondylitis ◽  
Local Steroid Injection ◽  
Group 2 ◽  
Group 1

Background: Tennis elbow or Lateral epicondylitis is now a days a well known condition with mixed etiopathogenesis of inammation and microtear resulting in decreased hand grip strength. Among the various treatment options, therapeutic ultrasound and local steroid injection are commonly used in managing these patients, but comparative effectiveness of these two treatment procedures are often debated. To compare the efcacy of local cortic Aim of Study: osteroid injection versus therapeutic ultrasound in terms of improvement in painfree grip strength(PFGS) of affected upper limb. This i Method: nterventional study was conducted on 56 patients of both sexes within the age group of 18-60 years with unilateral Tennis elbow. They were randomly divided in two groups of same number(28 in each group)- Group-1: managed with local injection of steroid (methylprednisolone-10mg, single dose) with 2% of 0.5 ml lignocaine and Group-2 : managed with Therapeutic Ultrasound. Improvement of PFGS was assessed by hand held Dynamometer. Data collected at 0 week (Visit-1 or Pre-initiation), 3weeks (Visit-2 ), 6 weeks (Visit-3), 12 weeks (Visit-4). For PFGS score, in both Group-1 and Group-2, there Result: was signicant increase in subsequent visits (p<0.05). The mean PFGS score of Group-1 was signicantly higher than that of Group-2 in visit2(p<0.01), but in visit-3(p>0.05) & visit-4(p>0.05) there was no statistically signicant difference noted. Local Steroid injection & Conclusion: therapeutic ultrasound both are effective in improving PFGS. Though Local steroid injection is more effective in initial period, but in subsequent followups, the difference was statistically insignicant.

scholarly journals A better functional outcome with platelet rich plasma compared with local steroid injection in tennis elbow

2021 ◽  
Vol 7 (1) ◽  
pp. 24-28
Author(s):  
Shilp Verma ◽  
Anwar A ◽  
Alok Chandra Agarwal ◽  
Ranjeet Choudhary ◽  
Ankit Kumar Garg
Keyword(s):  
Steroid Injection ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Symptomatic Relief ◽  
Lateral Epicondylitis ◽  
Treatment Modalities ◽  
Functional Activities ◽  
Local Steroid Injection

Lateral epicondylitis commonly referred to as 'tennis elbow,' is mainly observed in the 3rd and 4th decade of life in around 2% -3% of the population. Treatment modalities for lateral epicondylitis include analgesics, immobilization, tennis elbow brace, local steroid infiltration, and ultrasound therapy. Recent studies have explored the effectiveness of platelet-rich plasma (PRP) injections in lateral epicondylitis. We used the block randomization technique. Two groups were prepared with 30 patients in each group. One group of patients received PRP and the other received local steroid injection. Patients were evaluated at the time of procedure and immediately after the procedure, at six weeks, three months, and six months, using the visual analog score and Liverpool's elbow score. At the end of 6 months, follow-up patients in the PRP injection group show good clinical and functional compare to the steroid group of patients. PRP and local corticosteroid injection provide symptomatic relief in the treatment of lateral epicondylitis. PRP infiltration gives better results in pain relief and functional activities with statically significant values when compared with corticosteroid injections.

scholarly journals Deep Friction Massage Versus Steroid Injection in the Treatment of Lateral Epicondylitis

Hand ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 56-59 ◽  
Author(s):  
Rosemary Yi ◽  
Walter W. Bratchenko ◽  
Virak Tan
Keyword(s):  
Grip Strength ◽  
Pain Score ◽  
Steroid Injection ◽  
Lateral Epicondylitis ◽  
Control Group ◽  
Dash Score ◽  
Massage Group ◽  
Cortisone Injection ◽  
Group 2

Background: The aim of the study was to determine the efficacy of deep friction massage in the treatment of lateral epicondylitis by comparing outcomes with a control group treated with splinting and therapy and with an experimental group receiving a local steroid injection. Methods: A randomized clinical trial was conducted to compare outcomes after recruitment of consecutive patients presenting with lateral epicondylitis. Patients were randomized to receive one of 3 treatments: group 1: splinting and stretching, group 2: a cortisone injection, or group 3: a lidocaine injection with deep friction massage. Pretreatment and posttreatment parameters of visual analog scale (VAS) pain ratings, Disabilities of the Arm, Shoulder and Hand (DASH) scores, and grip strength were measured. Results: Outcomes were measured at early follow-up (6-12 weeks) and at 6-month follow-up. There was a significant improvement in VAS pain score in all treatment groups at early follow-up. DASH score and grip strength improved in the cortisone injection group and the deep friction massage group at early follow-up; these parameters did not improve in the splinting and stretching group. At 6-month follow-up, only patients in the deep friction massage group demonstrated a significant improvement in all outcome measures, including VAS pain score, DASH score, and grip strength. Conclusions: Deep friction massage is an effective treatment for lateral epicondylitis and can be used in patients who have failed other nonoperative treatments, including cortisone injection.

scholarly journals Effectiveness of Autologous Blood and Steroid Injection in Tennis Elbow Based on Visual Analog Score Pain Score and Nirschl Stage

2020 ◽  
Vol 18 (1) ◽  
pp. 15-17
Author(s):  
Gopal Sagar DC
Keyword(s):  
Pain Score ◽  
Steroid Injection ◽  
Tennis Elbow ◽  
Corticosteroid Injection ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction: Lateral epicondylitis or Tennis elbow is one of the most common causes of lateral elbow pain. Local steroid injection is a time tested treatment for providing symptomatic relief. Local injection of autologous blood in a case of lateral epicondylitis provides pain relief due to its cellular and humoral factor and triggers a healing cascade. Aims: This study aims to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow. Methods: This is a Hospital based study on conducted in the Department of Orthopedics at Nepalgunj Medical College from July 2018 to June 2019. 42 patients with unilateral tennis elbow were divided into two groups-Group A-21 patients (Autologous Blood Injection) and Group B-21 patients (Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg (in 2 ml) of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Visual Analogue Scale pain score and Nirschl stage of patients were evaluated before injection and at 2, 6, and 12 weeks of injection were noted and analyzed. Results: Preinjection mean VAS pain score was - 7.48±0.75, 7.52±0.68 in Group A, and Group B respectively while the Nirschl stage was 5.62±0.59 and 5.6±0.5 in group A and B, these scores among two group was not statistically significant. At 2 weeks follow up both groups showed improvement without any significant difference between two groups (p=0.84 and 0.549), while group A had better improvement in VAS pain score at 6 weeks (p=0.001). At 12 weeks follow-up within each group, there was significant VAS pain and Nirschl stage improvement (p=0.001) but there was no significant difference between the two groups. Conclusion: Injection of autologous blood and corticosteroid injection is equally effective in the treatment of Tennis elbow at 12 weeks final follow-up.

scholarly journals Two-stage total hip arthroplasty for primary advanced septic arthritis of the hip in adults: comparison of debridement versus femoral head resection with spacer implantation

2020 ◽  
Author(s):  
Zhenzhong Li ◽  
Congcong Wei ◽  
Xiangke Li ◽  
Mengxuan Yao ◽  
Huijie Li
Keyword(s):  
Total Hip Arthroplasty ◽  
Septic Arthritis ◽  
Pain Score ◽  
Hip Arthroplasty ◽  
Leg Length ◽  
Two Stage ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background: To compare the outcomes of debridement and total hip arthroplasty (THA) with antibiotic-loaded spacer implantation and subsequent THA for the treatment of patients affected by primary advanced septic arthritis (SA) of the hip in adults. Methods: All of the 20 patients (20 hips) underwent two-stage surgery. Nine patients were submitted to surgical debridement first, and then THA (group 1), while 11 patients were treated with antibiotic-loaded spacer and subsequent THA (group 2). Patients were evaluated based on the recurrence of infection, Harris hip score, visual analogue scale (VAS) pain score and leg-length discrepancy. Results: No cases of infection, deep vein thrombosis, death, and loosening of hip prosthesis were observed during follow-up. The mean follow-up time was 29.09 ± 10.80 months in group 1, and 28.22 ± 14.80 months in group 2. Before the THA surgery, the mean leg-length discrepancy was 2.80 ± 2.03 cm in group 1, and 0.50 ± 0.23 cm in group 2 (P < 0.05). In the latest follow-up, The Harris hip scores of patients was 90.33 ± 4.85 in group 1 and 94.36 ± 2.34 in group 2 (P < 0.05), respectively. There was no statistical significant difference in VAS pain score of the hip between the two groups (P > 0.05). Conclusions: Antibiotic-loaded spacer and subsequent THA is an effective method for the treatment of advanced SA of the hip in adults due to it can control infection and significantly improve functional hip.

scholarly journals EFFECTIVENESS OF ULTRASOUND-GUIDED CORTICOSTEROID INJECTION AND ALCOHOL NEUROLYSIS IN THE TREATMENT OF MERALGIA PARESTHETICA DURING A 28-MONTH FOLLOW-UP PERIOD: A RETROSPECTIVE COHORT STUDY

2021 ◽  
Author(s):  
Özge Yapıcı ◽  
Meriç Uğurlar
Keyword(s):  
Corticosteroid Injection ◽  
Ultrasound Guided ◽  
Recurrence Rates ◽  
Meralgia Paresthetica ◽  
Femoral Cutaneous Nerve ◽  
Retrospective Clinical Study ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Objectives Meralgia paresthetica is a very rare sensory mononeuropathy of the lateral femoral cutaneous nerve (LFCN). The purpose of this study was to evaluate the outcomes and compare the results of ultrasound-guided corticosteroid injection and ultrasound-guided alcohol neurolysis in the treatment of meralgia paresthetica. Methods We performed a retrospective clinical study of 26 patients with a diagnosis of marelgia paresthetica with a duration of ≥10 months. The patients were divided into 2 groups, with the Group 1 receiving ultrasound-guided local corticosteroid injection and Group 2 receiving ultrasound-guided alcohol neurolysis to the entrapment site of the LFCN. Results The mean age of the patients in Group 1 was 42.2 years and in Group 2 was 40.8 years. The mean follow-up period of Group 1 was 28.7 months and Group 2 was 28.4 months. At the end of the follow-up period 9 patients in Group 1 and 10 patients in Group 2 declared full pain relief and improvement in cutaneous sensitivity. Conclusion Once meralgia paresthetica has persisted corticosteroid injection and alcohol neurolysis are both effective methods. Although the recurrence rates are higher in corticosteroid injection, both treatment methods decreased the pain and improved the patients’ satisfaction and long-term curative effect.

scholarly journals Manipulation of the Wrist for Management of Lateral Epicondylitis: A Randomized Pilot Study

2003 ◽  
Vol 83 (7) ◽  
pp. 608-616 ◽  
Author(s):  
Peter AA Struijs ◽  
Pieter-Jan Damen ◽  
Eric WP Bakker ◽  
Leendert Blankevoort ◽  
Willem JJ Assendelft ◽  
...  
Keyword(s):  
Success Rate ◽  
Large Scale ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Control Group ◽  
Muscle Stretching ◽  
Strengthening Exercises ◽  
Group 2 ◽  
Group 1

Abstract Background and Purpose. Lateral epicondylitis (“tennis elbow”) is a common entity. Several nonoperative interventions, with varying success rates, have been described. The aim of this study was to compare the effectiveness of 2 protocols for the management of lateral epicondylitis: (1) manipulation of the wrist and (2) ultrasound, friction massage, and muscle stretching and strengthening exercises. Subjects and Methods. Thirty-one subjects with a history and examination results consistent with lateral epicondylitis participated in the study. The subjects were randomly assigned to either a group that received manipulation of the wrist (group 1) or a group that received ultrasound, friction massage, and muscle stretching and strengthening exercises (group 2). Three subjects were lost to follow-up, leaving 28 subjects for analysis. Follow-up was at 3 and 6 weeks. The primary outcome measure was a global measure of improvement, as assessed on a 6-point scale. Analysis was performed using independent t tests, Mann-Whitney U tests, and Fisher exact tests. Results. Differences were found for 2 outcome measures: success rate at 3 weeks and decrease in pain at 6 weeks. Both findings indicated manipulation was more effective than the other protocol. After 3 weeks of intervention, the success rate in group 1 was 62%, as compared with 20% in group 2. After 6 weeks of intervention, improvement in pain as measured on an 11-point numeric scale was 5.2 (SD=2.4) in group 1, as compared with 3.2 (SD=2.1) in group 2. Discussion and Conclusion. Manipulation of the wrist appeared to be more effective than ultrasound, friction massage, and muscle stretching and strengthening exercises for the management of lateral epicondylitis when there was a short-term follow-up. However, replication of our results is needed in a large-scale randomized clinical trial with a control group and a longer-term follow-up.

scholarly journals The relative effectiveness of cross friction and Mill's manipulation as compared to cross friction alone in the treatment of lateral epicondylitis (tennis elbow)

2000 ◽  
Author(s):  
◽  
Junaid Shaik
Keyword(s):  
General Population ◽  
Sampling Methods ◽  
Tennis Elbow ◽  
Relative Effectiveness ◽  
Lateral Epicondylitis ◽  
Controlled Study ◽  
Group 2 ◽  
Prospective Controlled Study ◽  
Group 1

The purpose of this study was to determine the relative effectiveness of cross friction combined with Mill's manipulation compared to cross friction alone in the treatment of lateral epicondylitis. This was a prospective, controlled study. The study involved thirty subjects, fifteen randomly allocated into two groups. These patients were selected from the general population by purposive sampling methods. Group 1 received cross friction and Mill's manipulation while Group 2 received cross friction only. Each subject was treated 6 times over a three-week period. Patients were required to return for a one-month follow-up from the date of their last consultation.

The influence of continuous local wound infusion on postoperative pain in patients undergoing transfemoral amputation

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Christian Uhl ◽  
Thomas Betz ◽  
Andrea Rupp ◽  
Markus Steinbauer ◽  
Ingolf Töpel
Keyword(s):  
Pain Management ◽  
Pilot Study ◽  
Local Anaesthetic ◽  
Phantom Pain ◽  
Transfemoral Amputation ◽  
Postoperative Wound ◽  
Stump Pain ◽  
Management Protocol ◽  
Group 2 ◽  
Group 1

Abstract. Summary: Background: This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics. Patients and methods: We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively. Results: The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death. Conclusions: Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

Sign in / Sign up

Export Citation Format

Share Document