What is the role of botulinum toxin (BTX) in the treatment of lateral epicondylitis (tennis elbow)?

Updated: Oct 30, 2018
  • Author: Bryant James Walrod, MD; Chief Editor: Craig C Young, MD  more...
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In a study by Wong et al, the authors demonstrated that an injection of BTX decreased patients' pain from lateral epicondylitis at 4-12 weeks when compared with saline injection; however, there was an increased incidence of side effects in the BTX treated group, which included digit paresis and weakness of finger extension. [37] In addition, the trial was small (60 patients), most of the patients were women, and the blinding of the study may have been affected by some of the patients possibly knowing which treatment they received (4 patients experienced digit paresis and may have correctly deduced they received the BTX injection).

A study by Placzek et al also demonstrated improvement in painful symptoms arising from lateral epicondylitis when BTX injections were used compared with saline. [38] However, another randomized controlled trial demonstrated no significant difference when comparing injections of BTX and saline in the treatment of lateral epicondylitis. [39]

A double-blind randomized controlled study published in 2017 did not find significant differences between corticosteroid and botulinum toxin injections. [40]

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