Physical Medicine and Rehabilitation for Lateral Epicondylitis Medication

Updated: Sep 16, 2019
  • Author: John W Hawkins, DO; Chief Editor: Stephen Kishner, MD, MHA  more...
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Medication

Medication Summary

The goal of drug treatment in cases of lateral epicondylitis is pain control, in order to facilitate the performance of ADL.

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Nonsteroidal anti-inflammatory drugs (NSAIDs)

Class Summary

These agents have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase (COX) activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.

Diclofenac topical (Solaraze)

Designated chemically as 2-[(2,6-dichlorophenyl) amino] benzeneacetic acid, monosodium salt, with an empirical formula of C 14 H 10 Cl 2 NO 2 NA. Diclofenac is one of a series of phenylacetic acids that has demonstrated anti-inflammatory and analgesic properties in pharmacologic studies. It is believed to inhibit the activity of COX, which is essential in the biosynthesis of prostaglandins.

Ibuprofen (Motrin, Ibuprin, Advil, Excedrin IB)

DOC for patients with mild to moderate pain. Ibuprofen inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Naproxen (Naprosyn, Naprelan, Anaprox, Aleve)

For relief of mild to moderate pain. Naproxen inhibits inflammatory reactions and pain by decreasing the activity of COX, which is responsible for prostaglandin synthesis.

Celecoxib (Celebrex)

Inhibits primarily COX-2. COX-2 is considered an inducible isoenzyme, being induced by pain and inflammatory stimuli. Inhibition of COX-1 may contribute to NSAID GI toxicity. At therapeutic concentrations, COX-1 isoenzyme is not inhibited; thus, GI toxicity may be decreased. Seek the lowest dose of celecoxib for each patient.

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Corticosteroids

Class Summary

The medications have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.

Triamcinolone (Amcort, Aristospan Intra-articular)

For inflammatory dermatosis responsive to steroids. This agent decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and by reversing capillary permeability.

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Analgesics

Class Summary

Pain control is essential to quality patient care. Analgesics ensure patient comfort and have sedating properties, which are beneficial for patients who experience pain.

Acetaminophen (Tylenol, Aspirin-Free Anacin, Tempra, FeverAll)

DOC for pain in patients who have documented hypersensitivity to aspirin or NSAIDs, who have upper GI disease, or who are taking PO anticoagulants.

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