Healthy living
Body matters
Jabs don't cure tennis elbow
Steroid injections may help for a while but aren't effective long-term
People who are given steroid injection to treat "tennis elbow", caused by inflammation of the tendons in the arm, may find the pain comes back a year or so later, according to research published in the BMJ.
The study found that steroid injections were less effective than physiotherapy, or even just resting the joint and waiting to see what happened.
Researchers in Australia tested different treatments on three separate groups of patients with tennis elbow. The first was told to rest the arm and wait. They were also given instructions on how to avoid aggravating their pain.
A second group were given a local corticosteroid injection and advised to gradually return to normal activities.
The final group received physiotherapy for six weeks and were taught home exercises and self-manipulation.
Each group's progress was measured at six weeks, and again after a year. Steroid injections worked well in the short term, with 78 per cent of patients reporting improvements, followed closely by physiotherapy with a 65 per cent success rate. Least successful was the 'wait and see' approach. Only 27 per cent of patients who had no treatment said that their symptoms were improving after six weeks.
However after 52 weeks the steroid group was showing significantly poorer results than both other sets of patients. Nearly three quarters reported a recurrence in their tennis elbow. In contrast, patients who had physiotherapy, or no treatment, were much improved or completely recovered.
The researchers think that patients who take steroids probably begin to recover more quickly, but this encourages them to start doing activities that put too much stress on the weakened elbow. They conclude that tennis elbow will usually heal by itself if nothing is done.
What is tennis elbow?
Tennis elbow affects about five in 1000 adults every year, mostly between the ages of 40 and 50. The painful spot is on the outer side of the elbow, and usually is at its worst when you're using the arm, especially if twisting movements are involved. However some people find the pain is there all the time. The condition is caused by inflammation of a tendon, probably due to a small injury. They most happen because you've been doing repeated movements involving the forearm: using a screwdriver is a common trigger as, of course, is playing tennis.
How can I treat it?
- You can buy effective pain –relieving creams and gels over the counter and they will also help to reduce the inflammation.
- Try to take it easy for a few weeks even after the symptoms have subsided and then only gradually build up physical activities.
- Exercises that strengthen the muscles in the arm should help to prevent tennis elbow recurring in the future and if you can, ask the advice of a physiotherapist in the best exercises to do.
Reader comments
I have had tree cotozone injections in my elbow the pain keeps coming back after 3 to 4 months.I am now loking for an alternative.....if their is one..
Posted by: saf | 08/07/2008 20:47:52
I have had injections in both elbows and I'm in just as much pain now than before. I am now looking at alternative medicine before taking any further steps.
Posted by: sharon | 10/04/2008 10:41:55
Information on this site is for interest only and is not a substitute for professional medical advice. You should consult your own doctor about any specific health concerns.