Comparative Effectiveness of Ultrasound-Guided Tenoxicam and Corticosteroid Injections for Lateral Epicondylitis

This prospective, randomized, comparative clinical study aims to compare the effectiveness of ultrasound-guided corticosteroid and tenoxicam injections in patients with lateral epicondylitis. A total of 72 participants will be randomized into two groups. One group will receive an ultrasound-guided methylprednisolone injection and the other group will receive an ultrasound-guided tenoxicam injection. Participants will be evaluated at baseline and at 4 and 12 weeks after treatment. Clinical outcomes will include pain, upper extremity function, lateral epicondylitis-related disability, and grip strength. Ultrasonographic assessment, including tendon thickness and strain elastography, will also be performed to evaluate structural and mechanical changes in the common extensor tendon.

Inclusion Criteria: * Age between 18 and 65 years * History of elbow pain lasting longer than 3 months * Localized pain and tenderness on palpation over the lateral epicondyle on physical examination * Failure to improve with non-invasive treatment, including at least 6 weeks of NSAID treatment and splint use * Pain intensity of 5 or higher on the Visual Analog Scale (VAS) * Voluntary participation in treatment Exclusion Criteria: * History of injection treatment for lateral epicondylitis * Cervical radiculopathy * Carpal tunnel syndrome * History of elbow surgery * History of trauma or fracture of the forearm * Limitation of wrist extension due to traumatic hand injury * Skin infection in the lateral epicondyle region * Active infection or systemic inflammatory disease * Bleeding diathesis or anticoagulant use * Pregnancy or breastfeeding * Malignancy * Medical conditions that constitute a contraindication to local injections