Tennis Elbow

Introduction

Tennis elbow or lateral epicondylitis is a painful, rheumatological condition causing significant morbidity in patients.[1] The condition is one of the most common painful disorders that are encountered in the clinical practice by the family physicians. It is related to the overuse of the extensor tendons of the forearm although relatively little is known about its natural history.[2] The disease leads to significant curtailment in the mobility of the wrist and also affects the quality of the life. The disease is characterized by the tenderness at the epicondyle. The pathophysiological basis is poorly understood and is characterized by the degenerative process, injury, inflammation, and repair mechanisms.[3] On the basis of the pathophysiological mechanisms, growth factors and bone marrow elements have been tried to augment the local repair.[4] Platelet‑rich plasma (PRP) acts by angiogenesis, recruitment of repair cells, cell proliferation, growth factor expression, and increasing the tensile strength of the tissues.[5] Lateral epicondylitis has shown response to the physiotherapy, hot fomentation, and analgesics in majority of the patients. However, the disease is often resistant to therapy, leading to a prolonged period of functional limitation. The management of resistant cases includes local injections with PRP, autologous blood, prolotherapy, steroids, extracorporeal shock wave therapy, and anesthetic agents.[6] There is a paucity of evidence‑based data, which establish superiority of a particular treatment modality over others.[7] The data on the management of lateral epicondylitis from India are even scantier.[8,9] Previous studies have shown the benefits of steroids, PRP, autologous blood in resistant cases.[10] Local steroid injection has been shown to give a consistent, predictable short‑term relief from the pain, and the movement limitation.[11] To the best of our knowledge, the use of combined steroid and anesthetic agents has not been evaluated earlier. Hence, we conducted this study to evaluate the response to local infiltration with steroids and lignocaine in resistant cases of lateral epicondylitis.

Tennis Squad "THE BEASTS"

Works Cited

Marwaha, Vishal, et al. "Combined Steroid and Lignocaine Injection in Resistant Cases of Tennis Elbow: A Prospective, Interventional Study from India." Journal of Family Medicine & Primary Care, vol. 6, no. 3, Jul-Sep2017, pp. 498-501. EBSCOhost, doi:10.4103/2249-4863.222032.