Tennis Elbow: Do Injections Really Work?
For those of you that are looking for a quick read, you got it. NO!
For those of you that would like to read a little more, here’s the rest of the story. Tennis elbow is the common term for lateral epicondylalgia or lateral epicondylitis. Typically this presents as pain on the outside of the elbow that usually is provoked by gripping or resisted wrist extension. In a study comparing corticosteroid injection, placebo injection, corticosteroid injection and physical therapy, and placebo injection and physical therapy it was found that patients receiving a steroid injection did WORSE over the long run.
In the group of patients that received injections, 54% had symptoms recur one year later, comparted to only 29% of patients who had received physical therapy, and 38% who only no treatment. In another study, the steroid injection group was found to have a 74% recurrence rate compared to 8% in the physical therapy group. The evidence is pretty clear that patients receive a very short term pain relief and over the long term have more episodes of elbow pain following injection.
The evidence is pretty clear, steroid injections for tennis elbow should not be performed. There is also very little evidence to support the use of non-steroidal anti-inflammatory drugs (NSAIDs) for the management of elbow pain. So what are people with elbow pain supposed to do? In the short term, patients receiving physical therapy had more improvement than a wait and see approach. People do well with a graded activity program and some manual therapy techniques to help improve pain levels and improve tolerance for performance of strengthening exercises.
If you are having elbow pain, or tennis elbow, set up an appointment today.