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Tennis Elbow: Should corticosteroid injections be used?

The answer to this questions leans heavily towards no, but there may be some exceptions. Let me explain why.



In this article:

  • Short term gain vs. long term harm

  • What if I combine a steroid injection with physiotherapy?

  • When could steroid injections be useful?

Check out this video of the livestream I did in the Sports Injury Group about Tennis Elbow:



Short term gain vs. long term harm


The research shows that steroid injections better pain relief for the first 6 weeks compared to other treatments.


The problem is that when you look at the same patients 3, 6 and 12 months later, the ones who’ve had steroid injections are actually worse off than the ones who’ve not had steroid injections.


So steroid injections decrease your initial pain from your tennis elbow more quickly, but after 6 weeks it then seems to slow your recovery down. Other treatments like physiotherapy exercises, shockwave or injections like PRP may not reduce your pain as quickly, but they seem to allow your injury to heal better in the long run.


There is also evidence that suggests that people who have more than one corticosteroid injection for their tennis elbow are more likely to progress to having surgery.



What if I combine a steroid injection with physiotherapy?


This has been tried and it seems that the negative long term effect of the steroid injection still persists despite following it up with physiotherapy.


When could steroid injections be useful?


If the benefits of short term pain relief outweighs the negative effect of slow healing. For instance if someone has to complete an important test or exam that can significantly impact their life. Also if the pain is totally unbearable and not reacting to any other treatments, one could argue that a steroid injection may be an option.


Let me know if you have any questions. Need more help with an injury? You can consult me online via video call for an assessment of your injury and a tailored treatment plan.

Best wishes

Maryke


About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn, ResearchGate, Facebook, Twitter or Instagram.



References:

  1. Coombes BK, Bisset L, Vicenzino B. Management of lateral elbow tendinopathy: one size does not fit all. journal of orthopaedic & sports physical therapy 2015;45(11):938-49.

  2. Orchard JW, Saw R, Masci L. The use of ultrasound-guided injections for tendinopathies. Current Radiology Reports 2018;6(10):38.

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