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Local injection, naproxen, and simple analgesia led to similar 1 year rates of symptom relief in lateral epicondylitis

Design
Randomised {allocation concealed^*}, blinded (outcome assessor and statistician),^* placebo controlled trial with 12 months follow up.

Setting
23 primary care practices in North Staffordshire and South Cheshire, England.

Patients
164 patients who were 18–70 years of age (66% 45 y, 52% men) and had consulted their general practitioner because they had had a new episode of lateral epicondylitis. Exclusion criteria were a history of inflam-matory arthritis or gross structural abnormality of the elbow, contraindications to non-steroidal anti-inflammatory drugs (NSAIDs) or local steroid injection, pregnancy, or breast feeding. 98% of patients were included in the analysis for 4 week complete recovery, 96% for 4 week and 12 month pain severity, and 98% for 6 month pain severity.

Intervention
Patients were allocated to a local corticosteroid injection of methylprednisolone, 20 mg, and 1% lignocaine, 0.5 ml (n=53); enteric coated naproxen, 500 mg twice daily for 2 weeks (n=53); or placebo for 2 weeks . . . [Full text of this article]

Anthony S Dixon, MBChB

University of Hong Kong Hong Kong, China