Clinical efficacy of botulinum toxin in lateral elbow tendinopathy: A systematic review and meta-analysis of randomized controlled trials.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(13):27 Orthop Traumatol Surg Res . 2025 May;111(3):103733.What this means for my practice?
Clinicians should note that while botulinum toxin provides statistically significant pain relief in lateral elbow tendinopathy, its clinical impact is limited, with no meaningful change in grip strength or adverse events. The findings support its safety but highlight the need for larger, long-term trials to determine clinical utility. Limitations include small sample sizes, heterogeneity in injection sites and dosages, and absence of functional outcomes.
Study Summary
Eight studies including 438 patients with chronic lateral elbow tendinopathy were included in this systematic review and meta-analysis comparing botulinum toxin injection vs. placebo or corticosteroid injections. Pooled outcomes of interest included pain reduction, grip strength, and adverse events. Botulinum toxin significantly reduced pain, but the reduction did not reach the minimal clinically important difference. There was no significant improvement in grip strength or increased risk of adverse events. Overall, botulinum toxin may modestly reduce pain in the short term, but the clinical relevance remains uncertain.
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