Steroid injection in tennis elbow

Corticosteroid injection in tennis elbow

• while corticosteroid injections have been shown to improve short-term pain relief (4 to 6 weeks) compared with both placebo and bracing, there is evidence that the long-term outcome following corticosteroid injection for treatment of tennis elbow may be worse than no treatment or physiotherapy alone. (1)
• hydrocortisone acetate mixed with local anaesthetic may be used, and long acting steroids should be avoided as there is a risk of skin atrophy
• repeated corticosteroid injections should be avoided (1)

Care must be taken to avoid both the nerve medially (paralysis) and subcuticular adipose tissue (necrosis) (2)

1. Gaujoux-Viala C et al. Efficacy and safety of steroid injections for shoulder and elbow tendonitis: a meta-analysis of randomised controlled trials. Ann Rheum Dis. 2009 Dec;68(12):1843-9.

2. Coombes BK et al. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. 2010 Nov 20;376(9754):1751-67.