Corticosteroid injections for lateral epicondylitis (tennis elbow) are primarily associated with short-term symptom relief NICE CKS. They can provide improved pain, function, and global improvement outcomes at around 6 weeks compared with placebo, orthoses, physiotherapy, and oral NSAIDs NICE CKS. Short-term benefits, typically less than 12 weeks, have been observed for pain relief and functional improvement NICE CKS.
However, corticosteroid injections are not routinely offered for tennis elbow due to concerns about long-term outcomes and recurrence rates NICE CKS. At 1 year follow-up, individuals treated with corticosteroid injections may experience the same or more symptoms than those who did not receive an injection, and some may have worse long-term outcomes compared to those receiving physiotherapy or oral NSAID treatment NICE CKS. There is moderate-quality evidence suggesting that corticosteroid injections may increase the recurrence rate of tennis elbow compared with physiotherapy and a watch-and-wait approach at 6 weeks follow-up NICE CKS. Reported recurrence rates after corticosteroid injection have been as high as 37% at 6 months and 72% at 6 weeks NICE CKS. The BMJ Best Practice guide advises against the use of corticosteroid injections for this condition NICE CKS.
The main potential risks and negative implications associated with their use in lateral epicondylitis include higher recurrence rates and less favourable long-term outcomes compared to other treatments or no treatment NICE CKS. Clinicians are advised to explain the possible adverse effects and long-term implications of corticosteroid injections, which is considered good medical practice NICE CKS.