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.

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.

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 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.

Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis

2017 ◽  
Vol 3 (1) ◽  
pp. 1-5
Author(s):  
KM Gopinath ◽  
Madhuram Chowdry ◽  
BNR Kumar ◽  
TR Kanmani
Keyword(s):  
Comparative Study ◽  
Steroid Injection ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Tertiary Care ◽  
Disease Process ◽  
Lateral Epicondylitis ◽  
Care Hospital

ABSTRACT Introduction Tennis elbow is a common condition with unpromising several modalities of treatment. Many of these are not aimed at treating the disease process. Platelet-rich plasma (PRP) contains biological healing factors and shows promising results in tendinopathies. In this study, our aim was to evaluate the efficacy of autologous PRP vs steroid injection in the treatment of chronic recalcitrant lateral epicondylitis. Materials and methods A prospective randomized control trial was conducted in our tertiary care hospital. Sixty patients with chronic lateral humeral epicondylitis, not responding to oral medications, tennis elbow belt, and physiotherapy, aged between 18 and 60 years were included in the study. Patients were randomized into PRP or steroid injection group based on a computer-generated block randomization chart. All patients had a baseline assessment including visual analog pain scores, Disability assessment of Shoulder and Hand score (DASH), and Nirschl (Injury, Prevention, Cure and Care – Nirschl Pain Phase Scale of Athletic Overuse Injuries) scores, and the same was repeated at 2 weeks, 6 weeks, 3 months, and 6 months postintervention. Results Steroid treatment shows better outcome in short-term (p < 0.001) and PRP shows better outcome in long-term (p < 0.001) follow-up. All three scores – visual analog score (VAS), DASH, Nirschl – showed significant linear improvement with PRP treatment, whereas with steroid injection initially there was significant improvement up to 3 months and later recurrence of symptoms. No complications were noted with PRP injection. Conclusion Use of autologous PRP injections for the management of lateral epicondylitis has better long-term outcomes compared with steroid injection in terms of VAS, DASH, and Nirschl scores. Also in our trial we had no recurrence of symptoms in the PRP group, whereas pain recurred in six patients in steroid group and was treated successfully with PRP. How to cite this article Chowdry M, Gopinath KM, Kumar BNR, Kanmani TR. Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis. J Med Sci 2017;3(1):1-5.

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 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.

scholarly journals Tennis elbow brace and wrist cock-up splint in the management of tennis elbow: a comparative study

2020 ◽  
Vol 6 (4) ◽  
pp. 813
Author(s):  
Sandeep Gavhale ◽  
Harshit Dave ◽  
Hitesh Rohra ◽  
Vipul D. Shet ◽  
Ganesh Aher ◽  
...  
Keyword(s):  
Tennis Elbow ◽  
Symptomatic Relief ◽  
Lateral Epicondylitis ◽  
Post Treatment ◽  
Wrist Extension ◽  
Proper Patient Selection ◽  
Group 3 ◽  
Pre Treatment ◽  
Group 2 ◽  
Group 1

<p class="abstract"><strong>Background:</strong> The purpose of our study was to compare the efficacy of a wrist splint with a forearm counterforce strap brace in the management of tennis elbow.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted between January and December 2018 comprising of 75 patients suffering from lateral epicondylitis managed conservatively with splints. Patients were randomized into three treatment groups, group 1 received tennis elbow forearm brace, group 2 received wrist extension splint, group 3 received both tennis elbow forearm brace and wrist extension splint. The patient-rated tennis elbow evaluation (PRTEE) score and visual analogue scale (VAS) scores were calculated at 0, 3 and 6 weeks of the treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean difference of pre-treatment and post-treatment PRTEE score was significant in all three groups and was maximum for group 3 patients (32.42) followed by group 2 patients (27.04) followed by group 1 patients (20.06). Pre-treatment and post-treatment VAS score difference was maximum for group 3 patients.</p><p class="abstract"><strong>Conclusions:</strong> Significant symptomatic relief can be achieved in patients with tennis elbow by using either tennis elbow forearm brace or wrist extension splint or both. Provided proper patient selection and compliance, wrist extension splint achieves better symptomatic relief and functional outcome as compared to tennis elbow brace.</p>

scholarly journals Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Seyed Ahmad Raeissadat ◽  
Leyla Sedighipour ◽  
Seyed Mansoor Rayegani ◽  
Mohammad Hasan Bahrami ◽  
Masume Bayat ◽  
...  
Keyword(s):  
Whole Blood ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Pressure Pain Threshold ◽  
Lateral Epicondylitis ◽  
Autologous Whole Blood ◽  
Significant Difference ◽  
Group 2 ◽  
And Function

Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS), modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT) at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P>0.05). At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P<0.05). Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion.

scholarly journals A Comparative Study to Evaluate the Efficacy of Supervised Exercise Program and Cyriax Physiotherapy on Pain and Function in Lateral Epicondylitis

2021 ◽  
pp. 87-97
Author(s):  
Gouri Kalaskar ◽  
Pratik Phansopkar
Keyword(s):  
Comparative Study ◽  
Tennis Elbow ◽  
Therapeutic Ultrasound ◽  
Lateral Epicondylitis ◽  
Exercise Programme ◽  
Research Subjects ◽  
Supervised Exercise ◽  
Group I ◽  
Post Test ◽  
And Function

Aims: To see the effectiveness of supervised exercises and cyriax physiotherapy both including therapeutic ultrasound for improving pain and function in adults with lateral epicondylitis. Study Design: Comparative study- to find out the efficacy of effectiveness of two different interventions for reducing pain and improving function in patients with lateral epicondylitis Place and Duration of Study: Department of Musculoskeletal  Physiotherapy Sciences, Ravi Nair Physiotherapy College, Sawangi (Meghe), Wardha, for 12 months. Methodology: A total of 30 people with lateral epicondylitis (tennis elbow) were selected to take part in a comparative research. Subjects were randomized 1:1 to either (1) supervised exercise programme group, or (2) cyriax physiotherapy group. Over just a 4-week period, three times each week for a sum of 12 sessions, promptly after baseline evaluation and randomization, subjects received static stretching of Extensor Carpi Radialis Brevis followed by eccentric strengthening of the wrist extensors and Therapeutic Ultrasound in supervised exercise programme group. While those in cyriax physiotherapy group received deep transverse friction massage for 10 min immediately followed by Mill’s manipulation and Ultrasound. The study concluded at the 4 weeks. Results: Out of 30 patients half were placed in each group, where p=.0001. Significant increase in mean in the group I and II in pre ad post-test VAS score (4.20±0.77 and 5.20±0.67) and TEFS score pre and post-test (17.33±1.44 and 19.80±1.42). analysis showed significant improvement in both the groups. Conclusion: From the observations and results, the conclusion drawn that there is significant improvement in both the groups but effect of cyriax physiotherapy in the form of deep friction massage and mills manipulation combined with therapeutic ultrasound for improving pain on VAS and function on TEF scale.

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