Brooke K. Coombes of the University of Queensland in St. Lucia, Australia, and colleagues conducted a study to evaluate the effectiveness of corticosteroid injection, physiotherapy or both in 165 patients with unilateral lateral epicondylalgia -- tennis elbow -- of longer than six weeks' duration.
The patients were enrolled from July 2008 to May 2010 with a one-year follow-up in May 2011.
Patients were randomized to receive either corticosteroid injection, a placebo injection, a corticosteroid injection plus physiotherapy, or placebo injection plus physiotherapy.
The researchers found 83 percent with corticosteroid injection demonstrated lower complete recovery or much improvement at one year compared with 96 percent who got the placebo injection. Those who got the corticosteroid injection had a 54 percent greater recurrence rate compared to 12 percent of those who got the placebo.
There were no differences between physiotherapy and no physiotherapy at one year for complete recovery or much improvement, or recurrence, the study said.
Fifty-five percent of those with the corticosteroid injection demonstrated lower complete recovery or much improvement compared with 85 percent who got the the placebo injection.
"Contrary to our hypothesis and to a generally held clinical view, we found that physiotherapy provided no beneficial long-term effect on complete recovery or much improvement, recurrence, pain, disability, or quality of life," Coombes said in the statement. "However, physiotherapy should not be dismissed altogether because in the absence of the corticosteroid, it provided short-term benefit across all outcomes."
The findings were published in the Journal of the American Medical Association.