What role do corticosteroid injections play in the management of golfer's elbow, and when should they be considered?

Corticosteroid injections have a limited and cautious role in the management of golfer's elbow (medial epicondylitis). They may be considered for short-term symptom relief in patients with persistent pain that has not responded to initial conservative treatments such as activity modification, physiotherapy, and analgesia.

However, corticosteroid injections should be used judiciously because while they can provide rapid pain relief, evidence suggests that their benefits may be short-lived and there is a risk of symptom recurrence or tendon degeneration with repeated injections.

Current UK guidelines recommend prioritising non-invasive management strategies initially, reserving corticosteroid injections for cases where symptoms significantly impair function and have not improved after several weeks of conservative care.

Furthermore, the cost-effectiveness and long-term outcomes of corticosteroid injections in related tendinopathies, such as lateral epicondylitis, indicate that although injections may be effective in the short term, they do not improve long-term recovery and may lead to worse outcomes if overused (Korthals-de Bos et al., 2004).

Therefore, corticosteroid injections in golfer's elbow should be considered only after careful assessment, ideally as part of a broader management plan including physiotherapy, and with clear patient counselling about the potential risks and benefits.