Corticosteroids Worsen Long-Term Epicondylalgia Outcomes
Physical therapy has no significant impact on long-term outcome
TUESDAY, Feb. 5 (HealthDay News) -- Patients with unilateral lateral epicondylalgia have worse long-term outcomes after injection with a corticosteroid compared with placebo, according to a study published in the Feb. 6 issue of the Journal of the American Medical Association.
Brooke K. Coombes, Ph.D., from the University of Queensland in St Lucia, Australia, and colleagues randomly assigned 165 adults with unilateral lateral epicondylalgia lasting longer than six weeks to placebo injection, placebo injection plus physical therapy, corticosteroid injection, or corticosteroid injection plus physical therapy.
At one year, the researchers found that corticosteroid injection was worse than placebo injection in terms of lower complete recovery or much improvement (83 versus 96 percent; P = 0.01) and greater recurrence (54 versus 12 percent; P < 0.001). Similar results were observed at 26 weeks. Physical therapy had no significant effect on outcomes at 26 weeks or at one year. There was a significant interaction between corticosteroid injection and physical therapy noted at four weeks, with greater complete recovery or much improvement for patients receiving placebo plus physical therapy versus placebo alone, while there was no difference for patients receiving corticosteroids with or without physical therapy.
"In conclusion, among patients with chronic unilateral lateral epicondylalgia, there was a worse clinical outcome one year after corticosteroid injection compared with placebo, despite its short-term benefits," Coombes and colleagues write.