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: Treatment Study of Steroid Injection and Physical Therapy for Acute Lateral Epicondylitis

Eligibility criteria:
Inclusion Criteria:

          -  Age 18-70 years

          -  Pain from the lateral part of the elbow

          -  The pain increases on resisted dorsiflexion of the wrist with the elbow extended and
             the fingers flexed or the pain increases on resisted radial deviation of the wrist or
             the pain increases on resisted extension of the 3. finger

        Exclusion Criteria:

          -  Duration of complaints less than 2 weeks or more than 3 months

          -  The tenderness is located within the muscle body itself in the proximal part of the
             short radial extensors muscle of the wrist (Cyriax type IV)9.

          -  Treatment within the last 12 months for the same condition with corticosteroid
             injection or physiotherapy

          -  Bilateral complaints

          -  Previous surgical treatment for lateral epicondylitis

          -  Deformities of the elbow (congenital or acquired)

          -  Cervical radiculopathy or referred pain from neck or shoulder

          -  Previous fractures or tendon ruptures in the elbow

          -  Systemic musculoskeletal disease

          -  Previous allergic reactions to corticosteroids or lidocaine

          -  Contraindications to corticosteroids or NSAIDs:

               -  On-going or previous gastro-intestinal bleeding

               -  previous ulcer or dyspepsia, severe asthma

               -  on-going systemic infection

               -  local skin-infection

               -  recently vaccinated with live virus

               -  coagulopathies

               -  SLE

               -  severe liver- or kidney-disease

               -  heart failure

               -  diabetes

               -  use of warfarin or NSAIDS

          -  Pregnancy or breast-feeding

          -  Fertile females not on effective birth control

          -  Psycho-social or other reasons for not being able to participate throughout the study.
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.
Subject must be at most 70 Years

Eligibility (NLI label): Contradiction