Methods

A total of 48 patients with recalcitrant lateral epicondylalgia were randomly allocated to receive a single injection of botulinum toxin A (60 units in 1 ml of normal saline) or the same volume of 0.9% saline placed at a standardised injection site. The primary outcome was pain at rest (100 mm visual analogue scale) 4-week postinjection, although follow-up also occurred at eight and 16 weeks. A research assistant assessed adverse effects, including third- and fourth-finger extensor lag. The physician making the injection and recording outcomes was blind to intervention; patients were not.