Botox-Like Drug May Ease Tennis Elbow
Drug Relieved Pain Better Than Fake Drug in Small Study
Dec. 5, 2005 -- A drug that has the same active ingredient as Botox cuts
pain from tennis elbow, according to researchers in Hong Kong.
Tennis players aren't the only people who get . The term refers to overuse
of the arm and forearm resulting in irritation of muscles and tendons and elbow
The usual treatment options for tennis elbow include use of
anti-inflammatory medications, physical therapy, and localized steroid
injections. For severe or unrelenting cases, surgery may be necessary.
The study was small and mainly included women who had had "tennis
elbow" pain for several months. More studies are needed to see if the drug
helps other patients, write the researchers.
They included Shiu Man Wong, MBBCh, of the medicine department at Hong
Kong's North District Hospital.
The study appears in the Annals of Internal Medicine.
Wong's study included 60 people. Participants got injections near their
elbows. They were asked to avoid motions that trigger symptoms of tennis elbow
for two days after getting the shots. They were also told not to get any other
treatments for tennis elbow during the study.
Some patients got shots of a Botox-like drug called Dysport. For comparison,
others got placebo injections of saline solution (salt water) with no
Botox itself wasn't tested. Dysport, like Botox, contains botulinum
Dysport was developed in the U.K. in the early 1990s to treat several
neurological and eye-related conditions; it's also used to treat facial
wrinkles and other conditions, according to Dysport's web site.
Less Pain Reported
Participants rated their pain three times: at the study's start, four weeks
later, and 12 weeks later. Their grips were also tested at the same time.
Those in the Dysport group reported a drop in pain by the study's fourth
week. After 12 weeks, they still had less pain than those who had gotten the
shots of saline.
Patients hadn't been told which drug they'd gotten. Some may have guessed,
the researchers note.
Botulinum toxin can weaken muscles in or near the injection area, states a
In Wong's study, the drug didn't weaken patients' grip. However, more
patients who got Dysport reported mild weakness in the fingers of their
Four weeks after their shot, 10 Dysport patients reported mild finger
weakness in the hand at the end of the treated arm. Two still had the problem
at the end of the study. Finger weakness interfered with one patient's work,
the researchers report.
Six people who got the saline shots reported the same problem in the study's
fourth week. One of those cases lasted for the rest of the study.
The frequency, severity, and duration of the drug's side effects need
further study, the researchers write.
How Does It Work?
Wong's team doesn't know how botulinum toxin eases pain.
They mention that in another study by other researchers, botulinum toxin
shots didn't work better than a placebo in patients with tennis elbow.
Those patients had milder symptoms and their shots were placed a bit farther
from the elbow, Wong's team notes.
In an editorial, Seth Pullman, MD, notes an expanding list of uses for drugs
containing botulinum toxin. He calls the use of botulinum toxin to treat pain
Pullman works at Columbia University Medical Center. He didn't work on