Pragmatic randomised controlled trial of local corticosteroid injection and naproxen for treatment of lateral epicondylitis of elbow in primary care.

Abstract:

OBJECTIVE:To compare the clinical effectiveness of local corticosteroid injection, standard non-steroidal anti-inflammatory drugs, and simple analgesics for the early treatment of lateral epicondylitis in primary care. DESIGN:Multicentre pragmatic randomised controlled trial. SETTING:23 general practices in North Staffordshire and South Cheshire. PARTICIPANTS:164 patients aged 18-70 years presenting with a new episode of lateral epicondylitis. INTERVENTIONS:Local injection of 20 mg methylprednisolone plus lignocaine, naproxen 500 mg twice daily for two weeks, or placebo tablets. All participants received a standard advice sheet and co-codamol as required. MAIN OUTCOME MEASURES:Participants' global assessment of improvement (five point scale) at four weeks. Pain, function, and "main complaint" measured on 10 point Likert scales at 4 weeks, 6 months, and 12 months. RESULTS:Over 2 years, 53 subjects were randomised to injection, 53 to naproxen, and 58 to placebo. Prognostic variables were similar between groups at baseline. At 4 weeks, 48 patients (92%) in the injection group were completely better or improved compared with 30 (57%) in the naproxen group (P<0.001) and 28 (50%) in the placebo group (P<0.001). At 12 months, 43 patients (84%) in the injection group had pain scores 0.05). CONCLUSIONS:Early local corticosteroid injection is effective for lateral epicondylitis. Outcome at one year was good in all groups, and effective early treatment does not seem to influence this.

journal_name

BMJ

authors

Hay EM,Paterson SM,Lewis M,Hosie G,Croft P

doi

10.1136/bmj.319.7215.964

keywords:

subject

Has Abstract

pub_date

1999-10-09 00:00:00

pages

964-8

issue

7215

eissn

0959-8138

issn

1756-1833

journal_volume

319

pub_type

临床试验,杂志文章,多中心研究,随机对照试验
  • Outcome of low back pain in general practice: a prospective study.

    abstract:OBJECTIVES:To investigate the claim that 90% of episodes of low back pain that present to general practice have resolved within one month. DESIGN:Prospective study of all adults consulting in general practice because of low back pain over 12 months with follow up at 1 week, 3 months, and 12 months after consultation. ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.316.7141.1356

    authors: Croft PR,Macfarlane GJ,Papageorgiou AC,Thomas E,Silman AJ

    更新日期:1998-05-02 00:00:00

  • Maternal age and fetal loss: population based register linkage study.

    abstract:OBJECTIVE:To estimate the association between maternal age and fetal death (spontaneous abortion, ectopic pregnancy, stillbirth), taking into account a woman's reproductive history. DESIGN:Prospective register linkage study. SUBJECTS:All women with a reproductive outcome (live birth, stillbirth, spontaneous abortion ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.320.7251.1708

    authors: Nybo Andersen AM,Wohlfahrt J,Christens P,Olsen J,Melbye M

    更新日期:2000-06-24 00:00:00

  • Painful crises in sickle cell disease--patients' perspectives.

    abstract::One hundred and two patients returned structured questionnaires sent to clinics for sickle cell disease in the United Kingdom in order to gain greater insight into the patients' perception of painful crises. Most patients who suffer pain crises experience a prodromal stage that should be investigated further to find o...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.297.6646.452

    authors: Murray N,May A

    更新日期:1988-08-13 00:00:00

  • Effects of legislation restricting pack sizes of paracetamol and salicylate on self poisoning in the United Kingdom: before and after study.

    abstract:OBJECTIVE:To evaluate the effects on suicidal behaviour of legislation limiting the size of packs of paracetamol and salicylates sold over the counter. DESIGN:Before and after study. SETTING:UK population, with detailed monitoring of data from five liver units and seven general hospitals, between September 1996 and S...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.322.7296.1203

    authors: Hawton K,Townsend E,Deeks J,Appleby L,Gunnell D,Bennewith O,Cooper J

    更新日期:2001-05-19 00:00:00

  • Effects of spinal cord stimulation in angina pectoris induced by pacing and possible mechanisms of action.

    abstract:OBJECTIVE:To investigate the effects of spinal cord stimulation on myocardial ischaemia, coronary blood flow, and myocardial oxygen consumption in angina pectoris induced by atrial pacing. DESIGN:The heart was paced to angina during a control phase and treatment with spinal cord stimulation. Blood samples were drawn f...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6902.477

    authors: Mannheimer C,Eliasson T,Andersson B,Bergh CH,Augustinsson LE,Emanuelsson H,Waagstein F

    更新日期:1993-08-21 00:00:00

  • Commissioning a national programme of research and development on the interface between primary and secondary care.

    abstract::The first call for applications to the NHS research and development programme on the interface between primary and secondary care was advertised in February 1994. A total of 674 outline proposals were submitted and 54 (8%) secured funding. Projects have been commissioned in 16 of the 21 priority areas and around 6m po...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.311.7012.1080

    authors: Wisely J,Haines A

    更新日期:1995-10-21 00:00:00

  • What worries parents when their preschool children are acutely ill, and why: a qualitative study.

    abstract:OBJECTIVE:To identify and explore parents' concerns when young children become acutely ill. DESIGN:Qualitative study making use of semi-structured one to one and group interviews with parents of preschool children. SETTING:Disadvantaged inner city community. SUBJECTS:95 parents of preschool children. RESULTS:Fever,...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7063.983

    authors: Kai J

    更新日期:1996-10-19 00:00:00

  • Birth weight and non-insulin dependent diabetes: thrifty genotype, thrifty phenotype, or surviving small baby genotype?

    abstract:OBJECTIVE:To determine the prevalence of diabetes in relation to birth weight in Pima Indians. DESIGN:Follow up study of infants born during 1940-72 who had undergone a glucose tolerance test at ages 20-39 years. SETTING:Gila River Indian community, Arizona. SUBJECTS:1179 American Indians. MAIN OUTCOME MEASURE:Prev...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.308.6934.942

    authors: McCance DR,Pettitt DJ,Hanson RL,Jacobsson LT,Knowler WC,Bennett PH

    更新日期:1994-04-09 00:00:00

  • Diet and cancer.

    abstract::Accumulating data indicate that modifications in diet may reduce the risk of cancer by as much as one third and possibly by as much as two thirds. On the basis of the existing evidence, however, it is not possible to be certain which cancers are causally related to diet and what proportion of them are due to specific ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.308.6944.1610

    authors: Austoker J

    更新日期:1994-06-18 00:00:00

  • The demand for neonatal intensive care.

    abstract::In a one year prospective study within the Trent Regional Health Authority the demand for neonatal intensive care was estimated to be 1.1 cots per 1000 births. Intensive care level 1 (as defined by the British Paediatric Association and British Association for Perinatal Paediatrics) was determined by two separate tech...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.299.6711.1305

    authors: Field DJ,Hodges S,Mason E,Burton P,Yates J,Wale S

    更新日期:1989-11-25 00:00:00

  • Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial.

    abstract:OBJECTIVES:To study the effects of metformin on the incidence of vitamin B-12 deficiency (<150 pmol/l), low concentrations of vitamin B-12 (150-220 pmol/l), and folate and homocysteine concentrations in patients with type 2 diabetes receiving treatment with insulin. DESIGN:Multicentre randomised placebo controlled tri...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.c2181

    authors: de Jager J,Kooy A,Lehert P,Wulffelé MG,van der Kolk J,Bets D,Verburg J,Donker AJ,Stehouwer CD

    更新日期:2010-05-20 00:00:00

  • Effect of a very low energy diet on moderate and severe obstructive sleep apnoea in obese men: a randomised controlled trial.

    abstract:OBJECTIVE:To assess the effect of weight loss induced by a very low energy diet on moderate and severe obstructive sleep apnoea in obese men. Design Single centre, two arm, parallel, randomised, controlled, open label trial. Blocked randomisation procedure used for treatment allocation. Setting Outpatient obesity clini...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.b4609

    authors: Johansson K,Neovius M,Lagerros YT,Harlid R,Rössner S,Granath F,Hemmingsson E

    更新日期:2009-12-03 00:00:00

  • Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study.

    abstract:OBJECTIVES:To assess the compliance of Asian intensive care units and hospitals to the Surviving Sepsis Campaign's resuscitation and management bundles. Secondary objectives were to evaluate the impact of compliance on mortality and the organisational characteristics of hospitals that were associated with higher compli...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.d3245

    authors: Phua J,Koh Y,Du B,Tang YQ,Divatia JV,Tan CC,Gomersall CD,Faruq MO,Shrestha BR,Gia Binh N,Arabi YM,Salahuddin N,Wahyuprajitno B,Tu ML,Wahab AY,Hameed AA,Nishimura M,Procyshyn M,Chan YH,MOSAICS Study Group.

    更新日期:2011-06-13 00:00:00

  • Non-specific immunological effects of selected routine childhood immunisations: systematic review.

    abstract:OBJECTIVE: To identify and characterise non-specific immunological effects after routine childhood vaccines against BCG, measles, diphtheria, pertussis, and tetanus. DESIGN: Systematic review of randomised controlled trials, cohort studies, and case-control studies. DATA SOURCES: Embase, PubMed, Cochrane library, and...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.i5225

    authors: Kandasamy R,Voysey M,McQuaid F,de Nie K,Ryan R,Orr O,Uhlig U,Sande C,O'Connor D,Pollard AJ

    更新日期:2016-10-13 00:00:00

  • Total hip arthroplasty versus resurfacing arthroplasty in the treatment of patients with arthritis of the hip joint: single centre, parallel group, assessor blinded, randomised controlled trial.

    abstract:OBJECTIVES:To compare the clinical and cost effectiveness of total hip arthroplasty with resurfacing arthroplasty in patients with severe arthritis of the hip. DESIGN:Single centre, two arm, parallel group, assessor blinded, randomised controlled trial with 1:1 treatment allocation. SETTING:One large teaching hospita...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.e2147

    authors: Costa ML,Achten J,Parsons NR,Edlin RP,Foguet P,Prakash U,Griffin DR,Young Adult Hip Arthroplasty Team.

    更新日期:2012-04-19 00:00:00

  • Failure to realise growth potential in utero and adult obesity in relation to blood pressure in 50 year old Swedish men.

    abstract:OBJECTIVES:To clarify the type of fetal growth impairment associated with increased blood pressure in adult life, and to establish whether this association is influenced by obesity and is mediated through impairment of insulin action. DESIGN:Cross sectional survey with retrospective ascertainment of size at birth from...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7028.401

    authors: Leon DA,Koupilova I,Lithell HO,Berglund L,Mohsen R,Vagero D,Lithell UB,McKeigue PM

    更新日期:1996-02-17 00:00:00

  • Birth weight of offspring and mortality in the Renfrew and Paisley study: prospective observational study.

    abstract:OBJECTIVE:To investigate the association between birth weight of offspring and mortality among fathers and mothers in the west of Scotland. DESIGN:Prospective observational study. PARTICIPANTS:794 married couples in Renfrew district of the west of Scotland. MAIN OUTCOME MEASURES:Mortality from all causes and from ca...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.315.7117.1189

    authors: Davey Smith G,Hart C,Ferrell C,Upton M,Hole D,Hawthorne V,Watt G

    更新日期:1997-11-08 00:00:00

  • Sharing of clinical trial data among trialists: a cross sectional survey.

    abstract:OBJECTIVE:To investigate clinical trialists' opinions and experiences of sharing of clinical trial data with investigators who are not directly collaborating with the research team. DESIGN AND SETTING:Cross sectional, web based survey. PARTICIPANTS:Clinical trialists who were corresponding authors of clinical trials ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e7570

    authors: Rathi V,Dzara K,Gross CP,Hrynaszkiewicz I,Joffe S,Krumholz HM,Strait KM,Ross JS

    更新日期:2012-11-20 00:00:00

  • Cost effectiveness of day and inpatient psychiatric treatment: results of a randomised controlled trial.

    abstract:OBJECTIVE:To compare direct and indirect costs of day and inpatient treatment of acute psychiatric illness. DESIGN:Randomised controlled trial with outcome and costs assessed over 12 months after the date of admission. SETTING:Teaching hospital in an inner city area. SUBJECTS:179 patients with acute psychiatric illn...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.314.7091.1381

    authors: Creed F,Mbaya P,Lancashire S,Tomenson B,Williams B,Holme S

    更新日期:1997-05-10 00:00:00

  • Endovascular or open repair strategy for ruptured abdominal aortic aneurysm: 30 day outcomes from IMPROVE randomised trial.

    abstract:OBJECTIVE:To assess whether a strategy of endovascular repair (if aortic morphology is suitable, open repair if not) versus open repair reduces early mortality for patients with suspected ruptured abdominal aortic aneurysm. DESIGN:Randomised controlled trial. SETTING:30 vascular centres (29 UK, 1 Canadian), 2009-13. ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.f7661

    authors: IMPROVE Trial Investigators.,Powell JT,Sweeting MJ,Thompson MM,Ashleigh R,Bell R,Gomes M,Greenhalgh RM,Grieve R,Heatley F,Hinchliffe RJ,Thompson SG,Ulug P

    更新日期:2014-01-13 00:00:00

  • Cardiovascular mortality in Dutch men during 1996 European football championship: longitudinal population study.

    abstract:OBJECTIVE:To investigate whether an important football match increases stress to such an extent that it triggers acute myocardial infarction and stroke. DESIGN:Longitudinal study of mortality around 22 June 1996 (the day the Dutch football team was eliminated from the European football championship). Mortality on 22 J...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.321.7276.1552

    authors: Witte DR,Bots ML,Hoes AW,Grobbee DE

    更新日期:2000-12-23 00:00:00

  • Trends and comparison of female first authorship in high impact medical journals: observational study (1994-2014).

    abstract:OBJECTIVE:To examine changes in representation of women among first authors of original research published in high impact general medical journals from 1994 to 2014 and investigate differences between journals. DESIGN:Observational study. STUDY SAMPLE:All original research articles published in Annals of Internal Med...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.i847

    authors: Filardo G,da Graca B,Sass DM,Pollock BD,Smith EB,Martinez MA

    更新日期:2016-03-02 00:00:00

  • Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline.

    abstract:CLINICAL QUESTION:Do adults with atraumatic shoulder pain for more than 3 months diagnosed as subacromial pain syndrome (SAPS), also labelled as rotator cuff disease, benefit from subacromial decompression surgery? This guideline builds on to two recent high quality trials of shoulder surgery. CURRENT PRACTICE:SAPS is...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.l294

    authors: Vandvik PO,Lähdeoja T,Ardern C,Buchbinder R,Moro J,Brox JI,Burgers J,Hao Q,Karjalainen T,van den Bekerom M,Noorduyn J,Lytvyn L,Siemieniuk RAC,Albin A,Shunjie SC,Fisch F,Proulx L,Guyatt G,Agoritsas T,Poolman RW

    更新日期:2019-02-06 00:00:00

  • Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic outpatients: clinical outcome at one year.

    abstract::A study was conducted to investigate a novel approach to the prophylaxis of schizophrenic relapse. The treatment strategy comprised brief intermittent courses of neuroleptic agents begun as soon as non-psychotic symptoms believed to be early signs of relapse appeared. Fifty four stable, remitted outpatients meeting th...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.298.6679.985

    authors: Jolley AG,Hirsch SR,McRink A,Manchanda R

    更新日期:1989-04-15 00:00:00

  • International variation in radiation dose for computed tomography examinations: prospective cohort study.

    abstract:OBJECTIVE:To determine patient, institution, and machine characteristics that contribute to variation in radiation doses used for computed tomography (CT). DESIGN:Prospective cohort study. SETTING:Data were assembled and analyzed from the University of California San Francisco CT International Dose Registry. PARTICI...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.k4931

    authors: Smith-Bindman R,Wang Y,Chu P,Chung R,Einstein AJ,Balcombe J,Cocker M,Das M,Delman BN,Flynn M,Gould R,Lee RK,Yellen-Nelson T,Schindera S,Seibert A,Starkey J,Suntharalingam S,Wetter A,Wildberger JE,Miglioretti DL

    更新日期:2019-01-02 00:00:00

  • Differences in incomes of physicians in the United States by race and sex: observational study.

    abstract:OBJECTIVES: To estimate differences in annual income of physicians in the United States by race and sex adjusted for characteristics of physicians and practices. DESIGN: Cross sectional survey study. SETTING: Nationally representative samples of US physicians. PARTICIPANTS: The 2000-13 American Community Survey (ACS...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.i2923

    authors: Ly DP,Seabury SA,Jena AB

    更新日期:2016-06-07 00:00:00

  • Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials.

    abstract:OBJECTIVE:To systematically review and describe currently available approaches to supporting maintenance of weight loss in obese adults and to assess the evidence for the effectiveness of these interventions. DESIGN:Systematic review with meta-analysis. DATA SOURCES:Medline, PsycINFO, Embase, and the Cochrane Central...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.g2646

    authors: Dombrowski SU,Knittle K,Avenell A,Araújo-Soares V,Sniehotta FF

    更新日期:2014-05-14 00:00:00

  • Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal.

    abstract:OBJECTIVE:To review and critically appraise published and preprint reports of prediction models for diagnosing coronavirus disease 2019 (covid-19) in patients with suspected infection, for prognosis of patients with covid-19, and for detecting people in the general population at increased risk of becoming infected with...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.m1328

    authors: Wynants L,Van Calster B,Collins GS,Riley RD,Heinze G,Schuit E,Bonten MMJ,Damen JAA,Debray TPA,De Vos M,Dhiman P,Haller MC,Harhay MO,Henckaerts L,Kreuzberger N,Lohman A,Luijken K,Ma J,Andaur CL,Reitsma JB,Sergeant

    更新日期:2020-04-07 00:00:00

  • Audit of compliance with antenatal protocols.

    abstract:OBJECTIVE:To assess the implementation of action protocols dictated by antenatal risk factors noted at the initial (booking) antenatal visit. DESIGN:Retrospective study of 2000 women delivered between 1 March 1990 and 29 March 1991. SETTING:Maternity department of a district general hospital supporting a multiethnic ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.305.6863.1184

    authors: Yoong AF,Lim J,Hudson CN,Chard T

    更新日期:1992-11-14 00:00:00

  • Perceptions of stroke in the general public and patients with stroke: a qualitative study.

    abstract:OBJECTIVES:To gain insight into people's thoughts on stroke and to inform the development of educational strategies in the community. DESIGN:Focus group discussions: two groups of people who had a stroke and their carers, and two groups of members of the general public. SETTING:New South Wales, Australia. PARTICIPAN...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.324.7345.1065

    authors: Yoon SS,Byles J

    更新日期:2002-05-04 00:00:00