Botox-Like Drug May Ease Tennis Elbow

Drug Relieved Pain Better Than Fake Drug in Small Study

Medically Reviewed by Louise Chang, MD on December 05, 2005

Dec. 5, 2005 -- A drug that has the same active ingredient as Botox cutspain from tennis elbow, according to researchers in Hong Kong.

Tennis players aren't the only people who get tennis elbow. The term refers to overuseof the arm and forearm resulting in irritation of muscles and tendons and elbowpain.

The usual treatment options for tennis elbow include use ofanti-inflammatory medications, physical therapy, and localized steroidinjections. For severe or unrelenting cases, surgery may be necessary.

The study was small and mainly included women who had had "tenniselbow" pain for several months. More studies are needed to see if the drughelps other patients, write the researchers.

They included Shiu Man Wong, MBBCh, of the medicine department at HongKong's North District Hospital.

The study appears in the Annals of Internal Medicine.

Pain Study

Wong's study included 60 people. Participants got injections near theirelbows. They were asked to avoid motions that trigger symptoms of tennis elbowfor two days after getting the shots. They were also told not to get any othertreatments 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 nomedicine.

Botox itself wasn't tested. Dysport, like Botox, contains botulinumtoxin.

Dysport was developed in the U.K. in the early 1990s to treat severalneurological and eye-related conditions; it's also used to treat facialwrinkles and other conditions, according to Dysport's web site.

Less Pain Reported

Participants rated their pain three times: at the study's start, four weekslater, 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 fourthweek. After 12 weeks, they still had less pain than those who had gotten theshots of saline.

Patients hadn't been told which drug they'd gotten. Some may have guessed,the researchers note.

Muscle Weakness

Botulinum toxin can weaken muscles in or near the injection area, states ajournal editorial.

In Wong's study, the drug didn't weaken patients' grip. However, morepatients who got Dysport reported mild weakness in the fingers of theiraffected arm.

Four weeks after their shot, 10 Dysport patients reported mild fingerweakness in the hand at the end of the treated arm. Two still had the problemat 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'sfourth week. One of those cases lasted for the rest of the study.

The frequency, severity, and duration of the drug's side effects needfurther 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 toxinshots didn't work better than a placebo in patients with tennis elbow.

Those patients had milder symptoms and their shots were placed a bit fartherfrom the elbow, Wong's team notes.

In an editorial, Seth Pullman, MD, notes an expanding list of uses for drugscontaining botulinum toxin. He calls the use of botulinum toxin to treat pain"intriguing."

Pullman works at Columbia University Medical Center. He didn't work onWong's study.

Show Sources

SOURCES: Wong, S. Annals of Internal Medicine, Dec. 6, 2005; vol 143: pp 793-797. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Arthritis: Tennis Elbow." Pullman, S. Annals of Internal Medicine, Dec. 6, 2005; vol 143: pp 838-839. Annals of Internal Medicine: "Summaries for Patients: Botulinum Toxin as a Treatment for Tennis Elbow."

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