Article Text

Download PDFPDF
Randomised controlled trial
A single botulinum toxin injection at a precise anatomic point on the forearm reduces pain at rest, compared to placebo injection in patients with chronic refractory lateral epicondylitis
  1. Bill Vicenzino,
  2. Brooke K Coombes
  1. University of Queensland, Queensland, Australia
  1. Correspondence to Bill Vicenzino
    University of Queensland, Therapies building 84A, St Lucia Campus, Queensland, QLD Australia 4072; b.vicenzino{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Commentary on:


Botulinum toxin type A, historically used for neuromuscular conditions, is a new and unproven intervention for tendinopathy.


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.


Compared to saline, botulinum toxin produced a mean benefit of 14.1 mm (95% CI 5.8 to …

View Full Text


  • Competing interests None.