The objective of this study was to evaluate the pain intensity, disability, and hand functions in patients with chronic lateral epicondylitis and to determine the short- and long-term effects of steroid injection on pain, disability, and impaired hand function. Patients with chronic unilateral lateral epicondylitis and healthy normal controls [HNC] matched for age, body mass index [BMI], and hand dominancy were included. A pain questionnaire was used to determine the subjective pain and disability caused by lateral epicondylitis. Pressure pain thresholds [PPTs] on the lateral epicondyles of both patients and HNCs were measured with a pressure pain algometer. Isometric hand grip strength measurements were performed with a Jamar hand dynamometer, and lateral pinch grip strength measurements were performed with a pinchmeter. The mixture of 20 mg of methylprednisolone and 0.5 ml of prilocaine at two percent was injected deep into the subcutaneous tissues and muscles 1cm distal to the lateral epicondyle. Pain questionnaire, grip strength, lateral pinch, and PPT measurements were repeated at two weeks and three months after steroid injection. Sixty lateral epicondylitis patients and 30 HNCs participated. Compared with HNCs, patients with lateral epicondylitis had significantly increased pain and disability scores and decreased isometric hand grip strength and lateral pinch grip strength [p < .001]. Pain questionnaire scores of the patients showed statistically significant decrease, and isometric hand grip strength, lateral pinch grip strength, and PPTs showed statistically significant increase [p < .01] at the second week after injection. In all parameters, significant improvement was also observed at the third month after injection [p < .001].
Steroid injection is effective on pain, disability, and impaired hand functions with both its short- and long-term benefits in patients with lateral epicondylitis.
Hakan Genc, Burcu Duyur Cakit, Meryem Saracoglu, Bunyamin Koc, Hatice Rana Erdem. The Effects of Local Steroid Injection on Pain, Disability, and Hand Functions in Patients with Lateral Epicondylitis. Journal of Musculoskeletal Pain, March 2010, Vol. 18, No. 1, Pages 49-57