Comparing the efficacy of blind vs. ultrasound-guided injections in Lateral Epicondylitis: A prospective analysis

Lateral epicondylitis is a relatively common non-traumatic elbow disorder. It is a painful musculoskeletal condition that usually follows forceful repetitive pronation and supination. The aim of this study was to evaluate the advantages of ultrasound-guided injection in patients of Lateral Epicondylitis in comparison to non-image-guided blind injections. This comparative observational study was conducted on sixty patients who had clinical diagnosis of Lateral Epicondylitis. They were divided into two groups of thirty each (randomization done on odd even manner), one group underwent US-guided injections and the other group underwent the blind procedure by a specialist. Pain relief using the Visual Analog Scale (VAS) {score of 0-10} was recorded before the procedure, immediately after the procedure, one-week post-procedure, and six weeks post-procedure. Demographic characteristics, chief complaints, duration of symptoms, previous treatment taken, and complications post-procedure were gathered and compared between the two groups. All patients in both groups finished the period of study. Significant improvement in pain score and tenderness was found in both groups immediately after the injection, one-week post-procedure, and after six weeks post-procedure when compared to the baseline value (p value < 0.05). The US-guided group showed a better reduction in VAS scores immediately after the procedure and one-week post-procedure as compared to patients who were given blind injections, however no statistical difference was found at six weeks follow up. This study shows that US-guided injection relatively improves elbow pain and functional activities early and more effectively than blind/non-image-guided injections, although such results fade as time passes by.