Effect of valsalva maneouver on pain occurring during tennis elbow injection

Abstract EN

Objectives : We planned this study to evaluate the efficacy of the Valsalva maneuver on pain associated with local injection and compare it with that of attention-diverting.

Methodology : The study was carried out on 60 patients attending the outpatient clinic of Bab Al-Shaareya University Hospital with the following inclusion criteria : age over 18 years, patients with symptoms of tennis elbow for at least 6 months, pain reproduced on palpation of the common extensor origin, pain reproduced on resisted extension of the wrist with the elbow extended, positive ultrasound finding (erosions, tendon abnormality, calcification, or enthesophyte) and patients fail to respond to NSAIDS and bracing alone.

Grouping : Group (1) : 30 patients with tennis elbow were asked to perform Valsalva maneuver before local injection.

Group (2) : 30 patients with tennis elbow were given a rubber ball in the palm of the other hand.

Results : A highly significant reduction in pain was observed in the Valsalva group than the other group, where mean for the VAS was 3.6 in group one and 6.7 in group two.

Regarding severity of pain : 21 patients (70 %) in the Valsalva group had mild pain and 8, (26.7 %) with moderate pain and 3.3 % (only one) with severe pain, whereas none of the patients experienced mild pain in group two, 14 (46.7 %) patients with moderate pain and 16 (53.3 %) patients with severe pain.

Conclusions : In conclusion, we observed that the Valsalva maneuver performed before local injection decreased the severity of pain associated with local injection.