Abstract
IntroductionTennis elbow is a common musculoskeletal disorder; management options include physiotherapeutic, medical, surgical, and other forms of intervention. Some patients remain symptomatic despite best efforts. We present two patients who did not respond to medical and surgical treatments, and whose symptoms were relieved with duloxetine. This is the first report on the use of duloxetine to treat tennis elbow.Case presentationTwo mentally healthy young Asian women aged 32 and 27 years, each with tennis elbow of about 18 months duration continued to suffer pain despite treatment with analgesics, local steroid injections, physiotherapy, cryotherapy, ultrasound, and surgical release, among other interventions. Both showed substantial improvement within 4 to 6 weeks of receiving monotherapy with duloxetine 60 mg/day. Both were pain-free with continued treatment at a 6-month follow-up.ConclusionDuloxetine may be a useful treatment option in patients with chronic tennis elbow, even those who have failed conventional medical, physiotherapeutic, surgical, and other forms of management.
Highlights
Tennis elbow is a common musculoskeletal disorder; management options include physiotherapeutic, medical, surgical, and other forms of intervention
Lateral epicondylalgia or tennis elbow is a common cause of pain and disability; it often develops in non-athletes
It is recognized that the lateral epicondyle, the annular ligament, the radial head and the capitellum may contribute to the experience of pain in tennis elbow [1]
Summary
Lateral epicondylalgia or tennis elbow is a common cause of pain and disability; it often develops in non-athletes. Non-operative treatment is successful in effecting a resolution of symptoms in most patients Such conservative treatment options include analgesics, tennis elbow support, ultrasonic therapy, and splint immobilization. A 32-year-old woman, presented with symptoms of tennis elbow of the right limb of 18 months duration She had been treated with analgesics, splint immobilization and rest, local steroid infiltrations, ultrasonic therapy and autologous blood infiltration over a period of 1 year. She was prescribed duloxetine in a dose that was increased to 60 mg per day over 5 days; analgesic treatment was stopped She reported a gradual reduction in pain; VAS scores dropped to 40 after 3 weeks, and to 25 after 4 weeks. Both patients continued with duloxetine to a 6-month follow-up, at which time VAS scores were recorded as zero
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