Injection therapies for lateral epicondylalgia: a systematic review and Bayesian network meta-analysis

  title={Injection therapies for lateral epicondylalgia: a systematic review and Bayesian network meta-analysis},
  author={Wei Dong and Hans Goost and Xiang Lin and Christof Burger and Christian Paul and Zeng-li Wang and Fan‐lin Kong and Kristian Welle and Zhi-Chao Jiang and Koroush Kabir},
  journal={British Journal of Sports Medicine},
  pages={900 - 908}
Background There are many injection therapies for lateral epicondylalgia but there has been no previous comprehensive comparison, based on the Bayesian method. Methods The MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for appropriate literature. The outcome measurement was the pain score. Direct comparisons were performed using the pairwise meta-analysis, and network meta-analysis, based on a Bayesian model, was used to calculate the… 
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Patients who received electrophysiotherapy and physical therapy reported statistically and clinically improved scores in pain and function compared to placebo and may put patients at higher risk for adverse effects compared to other conservative treatments.
Shock-wave therapy versus corticosteroid injection on lateral epicondylitis: a meta-analysis of randomized controlled trials
A meta-analysis to assess whether SW is superior to CS in managing LE, both in terms of ameliorating pain and improving functionality assumes that SW may be a superior alternative for the treatment of LE.
The Efficacy of Platelet-Rich Plasma on Improving Pain and Function for Lateral Epicondylitis: A Systematic Review and Meta-analysis with Risk-of-Bias Assessment.
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Eccentric exercises were the most common and consistently effective treatment for tendinopathy across systematic reviews, and minimally invasive procedures were more effective compared to open surgical interventions.
Effects of trigger point dry needling on lateral epicondylalgia of musculoskeletal origin: a systematic review and meta-analysis
Low to moderate evidence suggests a positive effect of dry needling for pain, pain-related disability, pressure pain sensitivity and strength at short-term in patients with lateral epicondylalgia of musculoskeletal origin.
Comparative Efficacy and Safety of Nonsurgical Treatment Options for Enthesopathy of the Extensor Carpi Radialis Brevis: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials
Most patients experienced pain resolution after receiving placebo within 4 weeks of follow-up, and all treatments provided only small pain relief while increasing the odds of adverse events.
Effects of manual acupuncture and electroacupuncture for lateral epicondylalgia of musculoskeletal origin: a systematic review and meta-analysis
Low-level evidence suggests positive effects of acupuncture, but not electroacupuncture, for pain, related-disability, and strength, in LE of musculoskeletal origin, in the short term.
The effect of corticosteroid versus platelet-rich plasma injection therapies for the management of lateral epicondylitis: A systematic review
Corticosteroid injections provide rapid therapeutic effect in the short-term with recurrence of symptoms afterwards, compared to the relatively slower but longer-term effect of platelet-rich plasma.


Evidence for the effectiveness of electrophysical modalities for treatment of medial and lateral epicondylitis: a systematic review
Potential effectiveness of ultrasound and laser for the management of LE was found and high-quality RCTs examining different intensities are needed as well as studies focusing on long-term follow-up results.
Treating lateral epicondylitis with corticosteroid injections or non-electrotherapeutical physiotherapy: a systematic review
Corticosteroid injections have a short-term beneficial effect on lateral epicondylitis, but a negative effect in the intermediate term, and evidence on the long-term effect is conflicting.
The effect of platelet-rich plasma on clinical outcomes in lateral epicondylitis.
  • Z. Ahmad, R. Brooks, N. Rushton
  • Medicine
    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
  • 2013
Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review
Results support the belief that strength training decreases symptoms in tendinosis, and the short-term analgesic effect of manipulation techniques may allow more vigorous stretching and strengthening exercises resulting in a better and faster recovery process of the affected tendon in lateral epicondylitis.
Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy: a systematic review
Based on the best evidence synthesis, there is strong evidence that PRP injections are not efficacious in the management of chronic lateral elbow tendinopathy.
The effects of corticosteroid injection versus local anesthetic injection in the treatment of lateral epicondylitis: a randomized single-blinded clinical trial
For lateral epicondylitis, CSI has the best short-term treatment results yet the highest recurrent rates and the combination of CSI with other treatment option or with a change in injection technique from single injection to peppering injection may be promising.
Steroid injection therapy is the best conservative treatment for lateral epicondylitis: a prospective randomised controlled trial
On the basis of the results of this study, the authors advocate steroid injection alone as the first line of treatment for patients presenting with tennis elbow demanding a quick return to daily activities.
Treatment of Lateral Epicondylitis With Platelet-Rich Plasma, Glucocorticoid, or Saline
Neither injection of PRP nor glucocorticoid was superior to saline with regard to pain reduction in LE at the primary end point at 3 months, and neither had a short-term pain-reducing effect at 1 month in contrast to the other therapies.