Application of Botulinum Toxin in the Treatment of Refractory Lateral Epicondylitis: A Case Report
DOI:
https://doi.org/10.25759/spmfr.374Keywords:
Botulinum Toxins, Type A/therapeutic use, Pain Management, Physical Therapy Modalities, Tennis ElbowAbstract
Introduction: Lateral epicondylitis is a common cause of chronic elbow pain, often related to repeated muscle activity. Although there are several therapeutic options available, there is no consensus regarding treatment approach to the refractory condition.
Case Report: Male, 38–years-old, referred to the attending physician with pain in the right lateral epicondyle. Ultrasonography revealed aspects compatible with tendinopathy and extensor digitorum communis partial tendon rupture near the epicondyle. The patient underwent a rehabilitation program in a community centre but, due to lack of pain control, was referred for hospital Physical Medicine and Rehabilitation consultation. In this consultation the patient presented pain on the numerical scale (NS) 8/10 and QuickDASH 68.2 / 100. He underwent 4 mesotherapy sessions, but due to persistent complaints, 20 U of onabotulinumtoxin A were administered in the extensor carpi radialis and the extensor digitorum muscles guided by ultrasound. The patient maintained follow-up during 5 months, being discharged with NS 1/10 and QuickDASH 4.5 / 100.
Discussion: This case illustrates the possibility of successfully applying onabotulinumtoxin A in the treatment of epicondylitis. Studies have shown that administration of 20-60 U of botulinum toxin is effective in reducing pain. Thus, botulinum toxin represents a promising therapeutic option in the treatment of refractory epicondylitis.
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