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J Family Med Prim Care. 2017 Jul-Sep;6(3):498-501. doi: 10.4103/2249-4863.222032.

Combined steroid and lignocaine injection in resistant cases of tennis elbow: A prospective, interventional study from India.

Author information

Department of Rheumatology, Amrita University, School of Medicine, Kochi, Kerala, India.
Department of Medicine, Mayo Institute of Medical Science, Barabanki, Uttar Pradesh, India.
Department of Medicine, AFMC, Pune, Maharashtra, India.
Department of Endocrinology, Army Hospital (R&R), Delhi, India.



Tennis elbow or lateral epicondylitis is a chronic, painful condition and is often resistant to conventional therapy. We evaluated the benefits of a combined steroid and lignocaine injection in resistant cases of tennis elbow.

Materials and Methods:

In this prospective, interventional study, we included chronic lateral epicondylitis patients resistant to analgesics and physiotherapy. The pain was assessed by visual analog scale (VAS), and we included patients with a baseline VAS >4. All patients were given local infiltration at the painful site with methylprednisolone (1 ml) and lignocaine (1 ml) by the peppering technique. The primary outcome was the change in VAS from the baseline at the end of 7 and 28 days. The improvement is classified as good, moderate, or mild based on the reduction in VAS score by 3, 2, 1, respectively. Descriptive statistics and appropriate tests were used to analyze the results.


The study population (n = 63; male: female - 33:30) had a mean age of 36.2 ± 4.5 years and disease duration of 17.4 ± 5.8 weeks. After 1 week, 55 patients showed good improvement, three patients showed moderate improvement, two patients showed mild improvement, and three patients had no improvement. The improvement persisted till 28 days in all the patients and one patient who had not improved after 7 days did not report for 28 days follow-up.


Local infiltration with steroids and lignocaine is a useful modality of therapy for tennis elbow, especially in patients where ultrasonic therapy and conservative measures have failed.


Lateral epicondylitis; lignocaine; methylprednisolone; tendinopathy; tennis elbow

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