# TREATMENT OF LATERAL EPICONDYLITIS OF THE ELBOW WITH HYALURONIC ACID INJECTIONS

**Authors:** MAURO EMILIO CONFORTO GRACITELLI, LUIZA DE CAMPOS MOREIRA DA SILVA, JORGE HENRIQUE ASSUNÇÃO, FERNANDO BRANDÃO DE ANDRADE E SILVA, ARNALDO AMADO FERREIRA, EDUARDO ANGELI MALAVOLTA

PMC · DOI: 10.1590/1413-785220253302e289985 · 2025-10-13

## TL;DR

Hyaluronic acid injections significantly reduced pain and improved function in patients with elbow tendonitis, with no complications observed over 12 months.

## Contribution

Demonstrates the long-term efficacy and safety of hyaluronic acid injections for lateral epicondylitis.

## Key findings

- Pain scores at rest improved from 4.5 to 2.3 over 12 months (p<0.001).
- Pain during hand grip strength decreased from 5.8 to 2.8 over 12 months (p<0.001).
- Functional scores (SANE) also showed significant improvement.

## Abstract

The primary objective was to evaluate the efficacy of hyaluronic acid injections for lateral epicondylitis. Secondary objectives included assessing pain and functional outcomes at various time points following the injection.

This prospective cohort study included patients who received two hyaluronic acid injections one week apart after prior conservative treatment. Assessments were conducted at two and six weeks, and at three, six, and 12 months post-injection. Outcome measures were pain scores (Visual Analogue Scale), functional assessment (Single Assessment Numeric Evaluation), and injection site complications.

A total of 46 patients (52 elbows) were included. Significant improvements were observed in pain scores measured by VAS at rest, from 4.5±2.8 initially to 2.7±2.8 at 3 months and 2.3±3.0 at 12 months (p<0.001). Similar improvements were seen in VAS scores during maximum hand grip strength, from 5.8±3.1 initially to 2.8±3.4 at 12 months (p<0.001). SANE score also improved significantly. No complications were reported.

Treatment of lateral epicondylitis with hyaluronic acid showed statistically significant improvement in VAS scores at rest and during maximum hand grip strength, as well as in SANE scores, with no reported complications. Level of Evidence IV; Case Series.

## Linked entities

- **Diseases:** lateral epicondylitis (MONDO:0001875)

## Full-text entities

- **Diseases:** pain (MESH:D010146), LATERAL EPICONDYLITIS (MESH:D013716)
- **Chemicals:** HYALURONIC ACID (MESH:D006820)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12517549/full.md

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Source: https://tomesphere.com/paper/PMC12517549