Patient case (clinical description): A 17-year-old male comes to the office due to several months of right elbow pain.  The pain is worse with activity and limits his workouts and activities.  He has tried over-the-counter medications with limited relief.  Medical history is notable for eczema, and current medications include a topical hydrocortisone ointment.  He is sexually active with his girlfriend and uses condoms. He does not smoke or drink alcohol. He plays tennis most of the days of the week. The comprehensive evaluation shows pain on the lateral side of the elbow, made worse by pressure applied on the lateral epicondyle of the humerus and when making a fist with the elbow joint straightened. The patient has this pain since last year and had several courses of physical therapy.

Patient's own account: I'm 17, and I had to go to the doctor because I've been suffering from my right elbow for several months. The pain is even worse when I do sports and it kind of limits me for my workouts and activities. I tried over-the-counter medications but it didn't work much. I had eczema before and my medication is ointments that contain cortisone. I am sexually active as a 17-year-old guy, and I have a girlfriend, and we use condoms. I don't smoke or drink. I play tennis most days of the week. I did an exam that showed pain on the side of my elbow and it was worse when they applied some pressure on it and when I was putting my hand as a fist. I have had this pain since last year, and I had several sessions of physical therapy already.

Clinical trial: Mesotherapy In Lateral Epicondylitis

Eligibility criteria:
Inclusion Criteria:

          -  clinical diagnosis defined as pain over the lateral epicondyle provoked by palpation;

          -  A visual analogue scale (VAS) score for pain greater than 40mm;

          -  symptoms duration for more than 1 month.

        Exclusion Criteria:

          -  other diseases that can alter clinical evaluation detected through history, clinical
             examination, ultrasound or other exams for comorbidities such as carpal tunnel
             syndrome, cervical radiculopathy, elbow arthritis, intra-articular loose bodies,
             previous elbow surgery or clinically significant or recent trauma, fibromyalgia and
             major psychiatric conditions;

          -  VAS score for pain less than 40mm;

          -  any of the following treatments during the previous 4 weeks before baseline visit:
             physical therapy, bandage, mesotherapy and local corticosteroid injection or a
             combination of these: NSAIDS taken during the week previous to inclusion;

          -  pregnancy;

          -  allergy to any of the study drugs;

          -  severely immunosuppressed patients;

          -  known coagulopathies. During the study period, enrolled patients are not allowed to
             take oral corticosteroids, NSAIDs or receive any other medical intervention during the
             treatment period (physical therapy, bandage, mesotherapy and local corticosteroid
             injection or a combination of these).
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.


Eligibility (NLI label): Contradiction