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

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 * systemic lupus erythematodes * 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 …