Vasudeva Abhimanyu, Parihar Ritika, Neyaz Osama, Bharti Ajay, Handa Gita
Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India.
Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India.
J Family Med Prim Care. 2021 Dec;10(12):4502-4508. doi: 10.4103/jfmpc.jfmpc_1173_21. Epub 2021 Dec 27.
The aim of this study was to compare the effect of a steroid injection with conservative therapy (CT) versus CT alone on pain, functional limitations and the cross-sectional area (CSA) of the radial nerve (RN) in patients with lateral epicondylitis (LE).
In this clinical trial, seventy subjects in the age group of 30-60 years with a clinical diagnosis of LE were recruited. Patients received an ultrasound-guided steroid injection and CT (Group A, = 35) or CT alone (Group B, = 35). Pain intensity (numeric pain rating scale), functional limitations (Quick Disabilities of the Arm, Shoulder, and Hand questionnaire) and the CSA of RN (mm) using ultrasound were assessed at baseline, 4 and 12 weeks.
There was a significant difference in pain intensity ( < 0.05) at 4 weeks in favour of Group A but not at 12 weeks. A statistically significant difference was not present favouring either group concerning disability at both the follow-ups. The difference in CSA of the RN at the affected side in both groups A and B was not statistically significant at either the spiral groove or the antecubital fossa at baseline or the subsequent follow-ups.
The CT with a steroid injection proved to be more efficacious in the short term concerning pain intensity and functional limitations. The RN thickness is not increased in patients with LE, thereby refuting its role to some extent in the pathogenesis of LE.
本研究旨在比较类固醇注射联合保守治疗（CT）与单纯保守治疗对外侧肘髁炎（LE）患者疼痛、功能受限情况以及桡神经（RN）横截面积（CSA）的影响。
在这项临床试验中，招募了70名年龄在30至60岁之间、临床诊断为LE的受试者。患者接受超声引导下的类固醇注射及CT治疗（A组，n = 35）或单纯CT治疗（B组，n = 35）。在基线、4周和12周时评估疼痛强度（数字疼痛评分量表）、功能受限情况（手臂、肩部和手部快速残疾问卷）以及使用超声测量的RN横截面积（mm）。
4周时，A组在疼痛强度方面有显著差异（P < 0.05），但12周时无差异。在两次随访中，两组在残疾方面均无统计学上显著有利于任何一组的差异。在基线或随后的随访中，A组和B组患侧RN在螺旋沟或肘前窝处的CSA差异均无统计学意义。
在疼痛强度和功能受限方面，类固醇注射联合CT在短期内被证明更有效。LE患者的RN厚度并未增加，从而在一定程度上反驳了其在LE发病机制中的作用。
