FRIDAY, Nov. 16, 2018 -- At best, all treatments provide only small pain relief for tennis elbow, according to a review published online Oct. 31 in the American Journal of Sports Medicine.
Jayson Lian, from the Beth Israel Deaconess Medical Center in Boston, and colleagues conducted a systematic literature review to compare the efficacy and safety of 11 nonsurgical treatment options for extensor carpi radialis brevis described in randomized placebo-controlled trials.
The researchers included 36 randomized placebo-controlled trials, evaluating 11 different treatment modalities and involving a total of 2,746 patients. Only local corticosteroid injection improved pain at short-term follow-up; however, it was associated with pain worse than placebo at long-term follow-up. Laser therapy and local botulinum toxin injection improved pain at midterm follow-up. Extracorporeal shock wave therapy provided pain relief at long-term follow-up. Only laser therapy showed better outcomes for grip strength compared with placebo. All treatments increased adverse events compared with placebo. After receiving placebo, most patients experienced pain resolution within four weeks of follow-up.
"Based on this analysis, our overall recommendation is 'wait and see,'" a coauthor said in a statement. "However, for some groups 'wait and see' may not be a feasible option, so we recommend for these groups an intervention that is most effective in short-term."
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