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

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 QUESTION: In adults with lateral epicondylitis (tennis elbow), which of 3 regimens (local corticosteroid injection, 2 weeks of naproxen, or simple analgesia) is most effective?


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


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


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. …

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  • Sources of funding: Arthritis Research Campaign. UpJohn provided methylprednisolone injections; Syntex provided enteric coated naproxen.

  • For correspondence: Dr E M Hay, Staffordshire Rheumatology Centre, The Haywood, Burslem, Stoke-on-Trent ST6 7AG, UK. Fax +44 (0)1782 412236.

  • * See glossary.

  • Information provided by author.