AIM: Chronic radial epicondylitis (tennis elbow) is not a serious disease but patients may suffer greatly. If standard conservative and possibly operative treatment modalities have not been effective, patients need further therapy. First trials with injection of Botulinum toxin A (Btx A) have shown promising results. The purpose of the study was to clarify if a single injection of Btx A could be an efficient therapy for chronic radial epicondylitis. METHODS: In this study 16 patients received injections into the forearm extensors. The site of injection was determined by local tenderness and pain provocation on finger and wrist extension. RESULTS: A significant clinical improvement was already seen at 2 weeks following injection. The effect was noted up to the last follow-up at 2 years. Continuous and maximal pain during the last 48 h, as self-assessed on a visual analogue scale, was also significantly reduced. In a few cases a significant decrease of muscle strength was seen for the third finger two weeks after injection. It slowly returned thereafter. CONCLUSION: A single injection of Btx A was effective as therapy for chronic tennis elbow. It can be carried out in an out-patient setting, and allows the patient to continue working.
