Steroid injections

Abstract

Corticosteroid injections are widely used in the management of lateral epicondylitis, and are based on the theory of inflammatory pathogenesis of the disease. Basic science investigations, including studies based on intraoperative histology, have dispelled this theory, and suggest that inflammation does not play a major role in the pathogenesis of the disease. Concurrently, multiple randomized controlled studies have evaluated corticosteroid injections in comparison to placebo, physical therapy, platelet-rich plasma (PRP) injections, and other modalities. The evidence demonstrates that corticosteroids are generally safe and effective in the short-term. However, the long-term benefit has not been demonstrated, and some studies report a high rate of recurrence with longer recovery time compared to other or no interventions. Therefore, current evidence does not support the routine use of corticosteroid injections in the treatment of lateral epicondylitis, although there may be a role in some cases when short-term pain relief is desirable in order to increase patient compliance with a long-term rehabilitation process.