Botulinum injection provides relief of tennis elbow

Apr 26, 2010

An injection of botulinum toxin can provide relief for "tennis elbow" but needs to be injected properly to avoid potential paralysis, states a research article in CMAJ (Canadian Medical Association Journal).

The study, a randomized controlled trial of 48 patients, was performed at Imam Khomeini Hospital Complex, affiliated with the Tehran University of Medical Sciences that serves patients from all over Iran. It was conducted to introduce an easy and effective method for injection of botulinum toxin to be used in routine practice. Instead of a fixed injection site physicians determined the injection site based on each patient's forearm length. All participants' used in the study had undergone previous therapeutic interventions that failed.

It is very important when paralyzing a muscle to know the appropriate injection site. Injection at a fixed distance from anatomic landmarks, as was performed in previous clinical trials of botulinum toxin for the management of lateral epiconylitis (tennis elbow), could result in inadequate paralysis.

"We found that pain at rest and pain during maximum pinch were significantly reduced in patients with lateral epicondylitis [tennis elbow] after botulinum toxin was injected at the site based on precise anatomic measurement of each patient's forearm length," write Dr. Mortazavi, Iman Khomeini Hospital, Tehran University of Medical Sciences, Iran, and coauthors. "However, this method caused a decline in maximum strength and resulted in extensor lag."

The authors conclude that precise measurement to guide injection of botulinum toxin can be effective in the management of chronic "tennis elbow". However, it should be used for patients whose job does not require finger extension. Further research is needed to determine whether the pain-relieving effects of the treatment remain or diminish after four months.

In a related commentary, Dr. Rachelle Buchbinder of Monash University, Australia, writes that the high costs to an individual and society related to sick leave and disability from lateral epicondylitis mean there is a clear need to identify the most cost-effective therapies. However, , although shown to reduce pain, may not be the right therapy for everyone because its effect on function, quality of life and pain-free grip is unknown. Also, it can cause partial loss of movement of the third and fourth fingers which may be unacceptable for some people.

Explore further: Continued reliance on Windows XP in physician practices may threaten data security

More information:
Research www.cmaj.ca/cgi/doi/10.1503/cmaj.090906
Commentary www.cmaj.ca/cgi/doi/10.1503/cmaj.100358

add to favorites email to friend print save as pdf

Related Stories

No need for needles: Botox sponge treats intrinsic rhinitis

Oct 15, 2009

Injecting botulinum toxin (botox) to treat intrinsic or allergic rhinitis may be a thing of the past as researchers have now shown that sponges soaked in botox are equally effective in treating the condition. The research ...

Recommended for you

What are the chances that your dad isn't your dad?

14 hours ago

How confident are you that the man you call dad is really your biological father? If you believe some of the most commonly-quoted figures, you could be forgiven for not being very confident at all. But how ...

New technology that is revealing the science of chewing

Apr 15, 2014

CSIRO's 3D mastication modelling, demonstrated for the first time in Melbourne today, is starting to provide researchers with new understanding of how to reduce salt, sugar and fat in food products, as well ...

After skin cancer, removable model replaces real ear

Apr 11, 2014

(HealthDay)—During his 10-year struggle with basal cell carcinoma, Henry Fiorentini emerged minus his right ear, and minus the hearing that goes with it. The good news: Today, the 56-year-old IT programmer ...

Italy scraps ban on donor-assisted reproduction

Apr 09, 2014

Italy's Constitutional Court on Wednesday struck down a Catholic Church-backed ban against assisted reproduction with sperm or egg donors that has forced thousands of sterile couples to seek help abroad.

User comments : 0

More news stories

Down's chromosome cause genome-wide disruption

The extra copy of Chromosome 21 that causes Down's syndrome throws a spanner into the workings of all the other chromosomes as well, said a study published Wednesday that surprised its authors.

How kids' brain structures grow as memory develops

Our ability to store memories improves during childhood, associated with structural changes in the hippocampus and its connections with prefrontal and parietal cortices. New research from UC Davis is exploring ...

Ebola virus in Africa outbreak is a new strain

The Ebola virus that has killed scores of people in Guinea this year is a new strain—evidence that the disease did not spread there from outbreaks in some other African nations, scientists report.