Comparison between botulinum toxin and corticosteroid injection in the treatment of acute and subacute tennis elbow

A prospective, randomized, double-blind, active drug-controlled pilot study

Yu Ching Lin, Yuan Kun Tu, Sheng Shiung Chen, I. Ling Lin, Shih Ching Chen, How Ran Guo

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objective: To compare botulinum toxin type A injection with corticosteroid injection in the treatment of tennis elbow. Design: In this prospective, randomized, double-blind, drug-controlled trial,19 affected elbows of 16 patients were randomly assigned to receive injection with botulinum toxin type A (Botox group) or triamcinolone acetonide (steroid group). We used the Visual Analog Scale, pain-free grip strength, and World Health Organization Quality of Life Brief Questionnaire to assess the perception of pain, grip strength, and quality of life, respectively. Measures were performed before and at 4, 8, and 12 wks after the treatment. Results: Four weeks after the treatment, the Botox group had smaller decrease in pain (P = 0.02) but greater decrease in grip strength (P = 0.01). The difference in grip strength remained significant at 8 wks (P = 0.03). No significant differences in quality of life were observed throughout the study period. Conclusions: Corticosteroid is superior to botulinum toxin type A in relieving pain in tennis elbow at 4 wks after injection. Because botulinum toxin injection did not relieve pain significantly but is associated with weakness, the muscle weakness caused by botulinum toxin is unlikely to be the sole mechanism of the pain relief observed in previous studies.

Original languageEnglish
Pages (from-to)653-659
Number of pages7
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume89
Issue number8
DOIs
Publication statusPublished - Aug 2010

Fingerprint

Tennis Elbow
Botulinum Toxins
Hand Strength
Adrenal Cortex Hormones
Type A Botulinum Toxins
Injections
Pain
Pharmaceutical Preparations
Quality of Life
Therapeutics
Triamcinolone Acetonide
Pain Perception
Muscle Weakness
Elbow
Visual Analog Scale
Steroids

Keywords

  • Botulinum Toxin Type A
  • Corticosteroid
  • Humeral Lateral Epicondylitis
  • Tennis Elbow

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

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title = "Comparison between botulinum toxin and corticosteroid injection in the treatment of acute and subacute tennis elbow: A prospective, randomized, double-blind, active drug-controlled pilot study",
abstract = "Objective: To compare botulinum toxin type A injection with corticosteroid injection in the treatment of tennis elbow. Design: In this prospective, randomized, double-blind, drug-controlled trial,19 affected elbows of 16 patients were randomly assigned to receive injection with botulinum toxin type A (Botox group) or triamcinolone acetonide (steroid group). We used the Visual Analog Scale, pain-free grip strength, and World Health Organization Quality of Life Brief Questionnaire to assess the perception of pain, grip strength, and quality of life, respectively. Measures were performed before and at 4, 8, and 12 wks after the treatment. Results: Four weeks after the treatment, the Botox group had smaller decrease in pain (P = 0.02) but greater decrease in grip strength (P = 0.01). The difference in grip strength remained significant at 8 wks (P = 0.03). No significant differences in quality of life were observed throughout the study period. Conclusions: Corticosteroid is superior to botulinum toxin type A in relieving pain in tennis elbow at 4 wks after injection. Because botulinum toxin injection did not relieve pain significantly but is associated with weakness, the muscle weakness caused by botulinum toxin is unlikely to be the sole mechanism of the pain relief observed in previous studies.",
keywords = "Botulinum Toxin Type A, Corticosteroid, Humeral Lateral Epicondylitis, Tennis Elbow",
author = "Lin, {Yu Ching} and Tu, {Yuan Kun} and Chen, {Sheng Shiung} and Lin, {I. Ling} and Chen, {Shih Ching} and Guo, {How Ran}",
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AU - Chen, Sheng Shiung

AU - Lin, I. Ling

AU - Chen, Shih Ching

AU - Guo, How Ran

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AB - Objective: To compare botulinum toxin type A injection with corticosteroid injection in the treatment of tennis elbow. Design: In this prospective, randomized, double-blind, drug-controlled trial,19 affected elbows of 16 patients were randomly assigned to receive injection with botulinum toxin type A (Botox group) or triamcinolone acetonide (steroid group). We used the Visual Analog Scale, pain-free grip strength, and World Health Organization Quality of Life Brief Questionnaire to assess the perception of pain, grip strength, and quality of life, respectively. Measures were performed before and at 4, 8, and 12 wks after the treatment. Results: Four weeks after the treatment, the Botox group had smaller decrease in pain (P = 0.02) but greater decrease in grip strength (P = 0.01). The difference in grip strength remained significant at 8 wks (P = 0.03). No significant differences in quality of life were observed throughout the study period. Conclusions: Corticosteroid is superior to botulinum toxin type A in relieving pain in tennis elbow at 4 wks after injection. Because botulinum toxin injection did not relieve pain significantly but is associated with weakness, the muscle weakness caused by botulinum toxin is unlikely to be the sole mechanism of the pain relief observed in previous studies.

KW - Botulinum Toxin Type A

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KW - Humeral Lateral Epicondylitis

KW - Tennis Elbow

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