Among the variety of shots that have been tested for lateral epicondylitis – tennis elbow – is unclear which ones work and which do not, concludes a new systematic review.
Tennis elbow affects 1% to 3% of the population and most frequently between the ages of 45 and 54 years . Injection therapies have included glucocorticoids, platelet rich plasma (PRP), autologous blood, prolotherapy, hyaluronic acid, botulinum toxin, polidocanol, and glycosaminoglycan polysulfate.
In an effort to determine which therapies work best injection, researchers at Copenhagen University Hospital, Frederiksberg, Denmark, conducted a systematic review of 17 randomized controlled trials that evaluated eight different injection treatments in 1381 patients.
considered only two outcomes: the change in the intensity of pain and the possible adverse effects (including the number of adverse events leading to discontinuation of treatment).
Polysulfate glucocorticoids, polidocanol and glycosaminoglycans proved better than placebo for pain relief of tennis elbow, according to the report.
Botulinum toxin was marginally effective compared with placebo, but was associated with significant side effects.
The autologous blood, prolotherapy and hyaluronic acid were significantly more effective than placebo, but only prolotherapy was significantly better than placebo after considering the adverse effects.
The transient pain after the injections was common in all trials, but there were interruptions due to adverse events or serious adverse events as a result.