Tennis Elbow – to inject or not to inject?
I’m not a fan of cortical steroid injections. Repeated research has shown that while the initial pain relief can be significant, prolonged and repeated use starts to break down the tendons within the joint, like a fraying rope. Which inevitably leads to more pain and more problems.
Tennis Elbow is a complicated condition, often misdiagnosed and therefore mistreated, it isn’t uncommon to hear of patients having had treatment for many months without making significant progress (TOP TIP – if it isn’t improving within 4 – 6 weeks, get a 2nd opinion!).
Often the first treatment someone will receive when they go to the Doctor is a steroid injection to help with the pain. NOTE – this is pain relief NOT treatment. Treatment fixes the problem, pain relief just makes you more comfortable with the problem.
This latest study comparing physiotherapy, cortical steroid injections and “wait and see” shows some interesting results:
6 months after injury the steroid injections come out better – this is about how long the pain relief effects last so they should do better as these patients are pain free (not treated, just not in pain!)
However, these patients had the highest recurrence rates. Again, not a surprise – the pain relief wore off so they went back for more, original problem NOT treated.
Unsurprisingly (in my, obviously completely biased opinion!) physiotherapy had the best outcomes – patients needed less medication, needed less Doctor time and had almost no recurrence. Why? Because the actual problem was treated not just covered up with pain relief.
Pain relief is an amazing thing – it allows us to carry on and work around problems. But it is NOT a treatment.