Evidence based research

This article reports on a prospective, randomized study that compared the effectiveness of dexamethasone delivered via a self-contained iontophoresis patch to corticosteroid injections for treating lateral epicondylitis (tennis elbow).

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Study Overview

• Objective: To evaluate the effects of iontophoresis delivery of dexamethasone versus corticosteroid injection (dexamethasone or triamcinolone) on patient outcomes.

• Method: 82 patients were randomized into three groups: iontophoresis, dexamethasone injection, or triamcinolone injection. All groups followed the same hand therapy protocol.

• Primary Outcomes: Change in grip strength, pain, and function scores.

• Secondary Outcome: Return-to-work status.

• Follow-up: Baseline, post-treatment, and 6-month follow-up.

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Key Findings

• Short-Term Benefits of Iontophoresis:

  • The iontophoresis group showed a statistically significant improvement in grip strength at the conclusion of hand therapy compared with baseline.

  • This group was also more likely to get back to work without restriction compared with the injection groups at both post-treatment and 6-month follow-up.

• Equivalence in Long-Term Results:

  • By the 6-month follow-up, all three groups had equivalent results for all measured outcomes (grip strength, pain, and function).

• Pain and Function:

  • All groups had a statistically significant improvement in pain by the end of the study.

  • Statistically significant improvement in function was noted for the iontophoresis and dexamethasone injection groups after treatment and for all three groups at the 6-month follow-up.

• Mode of Delivery vs. Medication:

  • The two injection groups (dexamethasone and triamcinolone) had similar outcomes, which the authors suggest implies that the method of medication delivery may be more important than the specific medication used.

• Surgery Predictor: Patients whose grip strength improved less than 15% after therapy were more likely to require surgical intervention.

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Dexamethasone via iontophoresis produced significant short-term benefits for grip strength and unrestricted return to work. The study suggests that this iontophoresis technique for corticosteroid delivery may be considered a viable treatment option for patients with lateral epicondylitis, offering a less invasive alternative to injection with a sustained delivery method.

Would you like a detailed breakdown of the statistical results from the tables, such as the mean pain ratings or grip strength percentage differences?