Shiu Man Wong, MB BCh; Andrew C.F. Hui, MBBS; Po-Yee Tong, BSc; Dawn W.F. Poon, BSc; Evelyn Yu, BSc; Lawrence K.S. Wong, MD
ClinicalTrials.gov Identifier: NCT00119704
Grant Support: By a donation from New World Development Ltd.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Shiu Man Wong, MB BCh, PacifiCare, 12th Floor, Oterprise Square, 26 Nathan Road, Tsim Sha Tsui, Hong Kong, China; e-mail, email@example.com.
Current Author Addresses: Dr. S.M. Wong: Department of Medicine, North District Hospital, 9 Po Kin Road, Sheung Shui, Hong Kong, China.
Drs. Hui and L.K.S. Wong, Ms. Tong, and Ms. Yu: Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
Ms. Poon: Department of Occupational Therapy, Prince of Wales Hospital, Shatin, Hong Kong, China.
Author Contributions: Conception and design: S.M. Wong, A.C.F. Hui, L.K.S. Wong.
Analysis and interpretation of the data: S.M. Wong, A.C.F. Hui, L.K.S. Wong.
Drafting of the article: S.M. Wong, A.C.F. Hui.
Critical revision of the article for important intellectual content: S.M. Wong, A.C.F. Hui, L.K.S. Wong.
Final approval of the article: S.M. Wong.
Provision of study materials or patients: S.M. Wong, P.-Y. Tong, D.W.F. Poon.
Statistical expertise: S.M. Wong, P.-Y. Tong, E. Yu.
Obtaining of funding: S.M. Wong.
Administrative, technical, or logistic support: S.M. Wong, P.-Y. Tong, D.W.F. Poon.
Collection and assembly of data: S.M. Wong, P.-Y. Tong, D.W.F. Poon.
Wong S., Hui A., Tong P., Poon D., Yu E., Wong L.; Treatment of Lateral Epicondylitis with Botulinum Toxin: A Randomized, Double-Blind, Placebo-Controlled Trial. Ann Intern Med. 2005;143:793-797. doi: 10.7326/0003-4819-143-11-200512060-00007
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Published: Ann Intern Med. 2005;143(11):793-797.
Do botulinum toxin injections help or hurt patients with tennis elbow?
Sixty adults with pain from lateral epicondylitis that had persisted for longer than 3 months were randomly assigned to receive a single injection of botulinum toxin or normal saline. Pain scores, which were assessed 4 and 12 weeks later, were significantly lower in the botulinum group than in the group receiving saline injections. Four weeks after the injections were administered, the investigators observed finger extension weakness in 10 patients in the botulinum group versus 6 patients in the saline group. Four of the patients who received the botulinum toxin also experienced digit paresis.
James R Korb
Southern California permanete Medical group
December 28, 2005
corticosteroids vs botulinum toxin
Wong et.al did a placebo controlled trial of botulinum toxin for lateral epicondylitis. I have often treated tennis elbow with an injection of lidocaine and steroids. In his editorial Pullman asserts that BTx injections are "less harmful" than corticosteroids. Since corticosteroids are a standard treatment for this condition, the study would have been more useful if they had compared corticosteroids with BTx. rather than placebo.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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