scholarly journals Efficacy of injection of steroids for lateral epicondylitis

1970 ◽  
Vol 32 (3) ◽  
pp. 34-38
Author(s):  
R Maharjan ◽  
G Gurung

Introduction: Lateral epicondylitis (Tennis elbow) is one of the most common lesions of the arm. Corticosteroid injection has been described as one of the treatment modalities for this disorder with variable clinical benefit. The purpose of this study was to analyze the short-term and long-term effects of the local injection of methylprednisolone to treat lateral epicondylitis. Methods: A prospective comparative study was carried out in the Department of Orthopaedics in Bir Hospital from October 2009 to February 2011. Study was undertaken in 40 patients to analyze the short-term and long-term effects of the local injection of methylprednisolone for the treatment of lateral epicondylitis. Twenty patients in each group were included in the study. Patients assigned to experimental group received a single injection of 1 percent lidocaine with forty milligrams of methylprednisolone and control group received a single injection of 1 percent lidocaine with saline solution. Results: Corticosteroid injection gave better pain relief in a shorter time than the placebo group. Pain was significantly improved in steroid group in comparison to placebo group till third successive follow ups with maximum improvement at eighteen weeks (p=0.000). However, the groups did not differ with regards to pain at six months as determined with a clinical pain score and visual analogue scale. Conclusions: Local injections of steroids provide rapid pain relief but only short-term benefits in the treatment of lateral epicondylitis. Key word: Epicondylities; Steroid injection; tennis elbow DOI: http://dx.doi.org/10.3126/joim.v32i3.4958 Journal of Institute of Medicine, December, 2010; 32:3 34-38

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S72-S73
Author(s):  
M. Hunter ◽  
A. Bhargava ◽  
E. Lang

Introduction: Lateral epicondylitis (LE), also known as tennis elbow, is an overuse-underuse tendinopathy originating from the forearm extensor tendons of the elbow. An emerging therapy for the treatment of LE is the use of transdermal nitroglycerin (NTG) patches for pain relief and improved function. Our systematic review assesses 18 to 65 year old patients with clinically diagnosed LE and no structural damage or longstanding elbow injury to determine if transdermal NTG patches provide improved short term and long term pain relief as well as improved function in comparison with placebo. Methods: We included randomised controlled trials (RCT’s) of NTG patch use versus placebo for the treatment of LE. Prospective comparison studies were also eligible for assessing the long term pain relief of NTG patch use. We performed a literature search using MEDLINE, EMBASE, SportDiscus and the Cochrane Database of Systematic Reviews. English language articles were retrieved for review up to November 2015. Risk of bias within the studies was assessed regarding randomisation, allocation sequence concealment, blinding and selective outcome reporting. Results: Three RCT’s were included that compared transdermal NTG patch use (two studies with 1.25mg/24h and one study comparing 0.72, 1.44 and 3.6mg/24h) versus a placebo to treat LE. One prospective comparison study of five years duration was included as a follow-up to one of the included RCT’s to assess pain and function five years after the discontinuation of therapy. Data was not pooled because of heterogeneity in study methods and outcomes. The use of transdermal NTG patches provided short term pain relief (2-6 weeks for dosing of 0.72mg/24h or 1.25mg/24h) compared with placebo as suggested by three RCT’s. Long term pain relief was improved by NTG patch use compared with placebo at six months in one RCT, but not at five years in a prospective comparison study. Function improved in two different RCT’s with NTG patch use at 0.72mg/24h and 1.25mg/24h when compared to placebo. Five years after cessation of treatment, there was no difference between NTG patch and placebo. Conclusion: Overall, the included studies demonstrate that the use of NTG patches compared to placebo improves short term and long term pain relief, as well as elbow function. However, more studies are required to bridge the gaps between the existing studies and reduce heterogeneity between the study designs.


2017 ◽  
Vol 3 (1) ◽  
pp. 1-5
Author(s):  
KM Gopinath ◽  
Madhuram Chowdry ◽  
BNR Kumar ◽  
TR Kanmani

ABSTRACT Introduction Tennis elbow is a common condition with unpromising several modalities of treatment. Many of these are not aimed at treating the disease process. Platelet-rich plasma (PRP) contains biological healing factors and shows promising results in tendinopathies. In this study, our aim was to evaluate the efficacy of autologous PRP vs steroid injection in the treatment of chronic recalcitrant lateral epicondylitis. Materials and methods A prospective randomized control trial was conducted in our tertiary care hospital. Sixty patients with chronic lateral humeral epicondylitis, not responding to oral medications, tennis elbow belt, and physiotherapy, aged between 18 and 60 years were included in the study. Patients were randomized into PRP or steroid injection group based on a computer-generated block randomization chart. All patients had a baseline assessment including visual analog pain scores, Disability assessment of Shoulder and Hand score (DASH), and Nirschl (Injury, Prevention, Cure and Care – Nirschl Pain Phase Scale of Athletic Overuse Injuries) scores, and the same was repeated at 2 weeks, 6 weeks, 3 months, and 6 months postintervention. Results Steroid treatment shows better outcome in short-term (p < 0.001) and PRP shows better outcome in long-term (p < 0.001) follow-up. All three scores – visual analog score (VAS), DASH, Nirschl – showed significant linear improvement with PRP treatment, whereas with steroid injection initially there was significant improvement up to 3 months and later recurrence of symptoms. No complications were noted with PRP injection. Conclusion Use of autologous PRP injections for the management of lateral epicondylitis has better long-term outcomes compared with steroid injection in terms of VAS, DASH, and Nirschl scores. Also in our trial we had no recurrence of symptoms in the PRP group, whereas pain recurred in six patients in steroid group and was treated successfully with PRP. How to cite this article Chowdry M, Gopinath KM, Kumar BNR, Kanmani TR. Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis. J Med Sci 2017;3(1):1-5.


Author(s):  
D.E. Loudy ◽  
J. Sprinkle-Cavallo ◽  
J.T. Yarrington ◽  
F.Y. Thompson ◽  
J.P. Gibson

Previous short term toxicological studies of one to two weeks duration have demonstrated that MDL 19,660 (5-(4-chlorophenyl)-2,4-dihydro-2,4-dimethyl-3Hl, 2,4-triazole-3-thione), an antidepressant drug, causes a dose-related thrombocytopenia in dogs. Platelet counts started to decline after two days of dosing with 30 mg/kg/day and continued to decrease to their lowest levels by 5-7 days. The loss in platelets was primarily of the small discoid subpopulation. In vitro studies have also indicated that MDL 19,660: does not spontaneously aggregate canine platelets and has moderate antiaggregating properties by inhibiting ADP-induced aggregation. The objectives of the present investigation of MDL 19,660 were to evaluate ultrastructurally long term effects on platelet internal architecture and changes in subpopulations of platelets and megakaryocytes.Nine male and nine female beagle dogs were divided equally into three groups and were administered orally 0, 15, or 30 mg/kg/day of MDL 19,660 for three months. Compared to a control platelet range of 353,000- 452,000/μl, a doserelated thrombocytopenia reached a maximum severity of an average of 135,000/μl for the 15 mg/kg/day dogs after two weeks and 81,000/μl for the 30 mg/kg/day dogs after one week.


Author(s):  
Chul Ki Goorens ◽  
Pascal Wernaers ◽  
Joost Dewaele

AbstractLateral epicondylitis (LE) of the elbow is often treated with conservative methods. Several techniques including injections with different substances are widely performed. No standardization exists. This prospective study describes the results of the short-term follow-up of 56 patients with mean age 48 years (range: 30–68 years) treated with the Instant Tennis Elbow Cure Medical device, which fenestrates the injured tendon in a standardized way through a holder of 12 small needles. Depth and position of the needles are determined beforehand by ultrasonography. Unprepared autologous blood was injected through the holder in the tendon. Visual analog pain scale (VAS) decreased significantly in rest by 61% and during activity by 47% after 6 weeks. VAS decreased significantly in rest by 79% and during activity by 66% after 3 months. VAS did not remain significantly different after 6 months. Satisfaction rates were 71% after 6 weeks and 82% after 6 months. This suggests that the therapeutical effect sustains and in some cases increases over time. Patient Related Tennis Elbow Evaluation score ameliorated after 3 months by 71%. Comparative studies are needed to confirm this effect versus other techniques as physiotherapy, shockwave therapy, and injections with other substances.


Psibernetika ◽  
2018 ◽  
Vol 11 (1) ◽  
Author(s):  
Devina Calista ◽  
Garvin Garvin

<p><em>Child abuse by parents is common in households. The impact of violence on children will bring short-term effects and long-term effects that can be attributed to their various emotional, behavioral and social problems in the future; especially in late adolescence that will enter adulthood. Resilience factors increase the likelihood that adolescents who are victims of childhood violence recover from their past experiences</em><em>,</em><em> become more powerful individuals and have a better life. The purpose of this study was to determine the source of resilience in late adolescents who experienced violence from parents in their childhood. This research uses qualitative research methods with in-depth interviews as a method of data collection. The result shows that the three research participants have the aspects of "I Have", "I Am", and "I Can"; a participant has "I Can" aspects as a source of resilience, and one other subject has no source of resilience. The study concluded that parental affection and acceptance of the past experience have role to the three sources of resilience (I Have, I Am, and I Can)</em></p><p><em> </em></p><p><strong><em>Keyword : </em></strong><em>Resilience, adolescence, violence, parents</em></p>


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 559-559
Author(s):  
Sara Freed ◽  
Briana Sprague ◽  
Lesley Ross

Abstract Interventions using exercise video games, or exergames, have shown short-term cognitive and physical benefits to older adults, though long-term effects are less promising. Enjoyment of exergames may promote exergame use after the intervention period, though little work has examined older adults’ views of exergames before and after gameplay experience. We invited 20 older adults between 65 and 84 years of age (M=73.30, SD=5.95) to play two Xbox Kinect games, Just Dance and Kinect Sports Rivals, for twenty minutes. In our presentation, we will present qualitative and quantitative findings of this pilot study, including findings that older adults reported that they were not likely to play similar exergames in the future and that they did not find the exergames to be more fun compared to other ways of exercising. We will discuss implications for game design and research relevant to game developers, manufacturers, and researchers. Part of a symposium sponsored by Technology and Aging Interest Group.


2021 ◽  
pp. 1-10
Author(s):  
Michihiro Osumi ◽  
Daisuke Shimizu ◽  
Yuki Nishi ◽  
Shu Morioka

Background: Patients with brachial plexus avulsion (BPA) usually experience phantom sensations and phantom limb pain (PLP) in the deafferented limb. It has been suggested that evoking the sensation of touch in the deafferented limb by stimulating referred sensation areas (RSAs) on the cheek or shoulder might alleviate PLP. However, feasible rehabilitation techniques using this approach have not been reported. Objective: The present study sought to examine the analgesic effects of simple electrical stimulation of RSAs in BPA patients with PLP. Methods: Study 1: Electrical stimulation of RSAs for 60 minutes was conducted for six BPA patients suffering from PLP to examine short-term analgesic effects. Study 2: A single case design experiment was conducted with two BPA patients to investigate whether electrical stimulation of RSAs was more effective for alleviating PLP than control electrical stimulation (electrical stimulation of sites on side opposite to the RSAs), and to elucidate the long-term effects of electrical stimulation of RSAs. Results: Study 1: Electrical stimulation of RSAs evoked phantom touch sensations in the deafferented limb, and significantly alleviated PLP (p <  0.05). Study 2: PLP was alleviated more after electrical stimulation on RSAs compared with control electrical stimulation (p <  0.05). However, the analgesic effects of electrical stimulation on RSAs were observed only in the short term, not in the long term (p >  0.05). Conclusions: Electrical stimulation of RSAs not only evoked phantom touch sensation but also alleviated PLP in the short term. The results indicate that electrical stimulation of RSAs may provide a useful practical rehabilitation technique for PLP. Future studies will be required to clarify the mechanisms underlying immediate PLP alleviation via electrical stimulation of RSAs.


2021 ◽  
Vol 13 (8) ◽  
pp. 4316
Author(s):  
Shingo Yoshida ◽  
Hironori Yagi

The coronavirus disease 2019 (Covid-19) pandemic has forced global food systems to face unprecedented uncertain shocks even in terms of human health. Urban agriculture is expected to be more resilient because of its short supply chain for urban people and diversified farming activities. However, the short-and long-term effects of the Covid-19 pandemic on urban farms remain unclear. This study aims to reveal the conditions for farm resilience to the Covid-19 pandemic in 2020 and the relationship between short-term farm resilience and long-term farm development using data from a survey of 74 farms located in Tokyo. The results are as follows. First, more than half of the sample farms increased their farm sales during this period. This resilience can be called the “persistence” approach. Second, short-term farm resilience and other sustainable farm activities contributed to improving farmers’ intentions for long-term farm development and farmland preservation. Third, the most important resilience attributes were the direct marketing, entrepreneurship, and social networks of farmers. We discussed the necessity of building farmers’ transformative capabilities for a more resilient urban farming system. These results imply that support to enhance the short-term resilience of urban farms is worth more than the short-term profit of the farms.


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