Cortisone injections lead to worse outcomes for tennis elbow

Cortisone injections have been almost routine treatments for patients with lateral epicondylitis – commonly known as “tennis elbow.” A study published in today’s issue of the Journal of the American Medical Association questions whether cortisone injections are effective and whether they should be used for this problem.

Brooke K Coombes, PhD et al performed a randomized controlled trial comparing adults undergoing a one-time injection of a corticosteroid versus a placebo injection, with and without a short course of physical therapy. They found that patients who received a single corticosteroid injection had a higher recurrence rate and worse long-term outcomes one year later than did those receiving a placebo injection.

The authors also noted other interesting findings:

    Corticosteroid injections provided a short-term benefit compared to placebo. However six months after receiving the injection, patients were found to have worse outcomes in terms of pain, disability and quality-of-life.
    More than half of patients who received a corticosteroid injection had a recurrence of their lateral epicondylitis, which was much higher than the placebo patients.
    Significantly fewer patients who received a corticosteroid injection claimed to be completely recovered than did those patients who received a placebo injection.
    Eight weeks of physical therapy did not improve patient outcomes long-term, but it did seem to provide short-term benefits to patients who did not receive a corticosteroid injection.

Are these results surprising?

Man with painful tennis elbowMost people reading this post might be surprised, because cortisone injections have been considered standard treatments for tennis elbow for years. In my experience the majority of patients who come to my office for evaluation and treatment of tennis elbow expect or request a cortisone shot.

On the other hand, many of us who specialize in sports medicine probably aren’t or won’t be surprised. In theory, cortisone injections shouldn’t effectively treat lateral epicondylitis. Why?

While the name lateral epicondylitis suggests an inflammatory problem, it actually isn’t one. If you biopsied the diseased tendons, you would find few inflammatory cells. Corticosteroids are anti-inflammatory medications. If there isn’t an inflammatory process present, an injection shouldn’t have an effect. Actually concern that the steroids would weaken the tendon is warranted.

Tennis elbow is actually a tendinopathy – a disease process where there is a small area of degeneration within the tendon. While the cortisone shot might provide short-term relief, it does not actually cause healing within the diseased tendon. The short-term relief might result from the local anesthetics in the injection or a placebo effect itself.

Bottom line

What message can patients take home from this study? First, and most importantly, they should avoid a cortisone injection as a first-line treatment for lateral epicondylitis. It is important to point out that most patients recover from this problem without long-term issues. The authors in this study showed that 90% of patients either had complete recovery or significant improvement at one year with a placebo injection – meaning it essentially resolved on its own.

Do these results surprise you? Have you had success – or failure – with cortisone injections for tennis elbow? Share your thoughts and experiences below!

Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B. Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia: A Randomized Controlled Trial. JAMA. February 6, 2013;309(5):461-9.

69 Responses to Cortisone injections lead to worse outcomes for tennis elbow

  1. I am currently in physical therapy for an acute case of lateral epicondylitis. Use of my right hand is greatly curtailed due to lack of grip. At the end of this session I am scheduled for a corticosteriod injection. People I have spoken to have reported excellent results with this treatment. I am surprised and confused by these findings.

    • That doesn’t surprise me. Many patients will get significant relief of their pain. But frequently the problem comes back in weeks or months. There has been suspicion for a long time in orthopaedic surgery that cortisone injections actually might be counterproductive, but we haven’t had much data. I don’t tell people that they should never try one, but I do discuss risks and benefits.

      • Dr. Geier, did the authors of the study mentioned above measure the subjects activity level pre vs. post-treatment (placebo)? The reason I ask this is that I believe the activity, not the cortisone shot, is responsible for the high rate of recurrence. If someone obtains relief from the cortisone shot but then returns to the exact same behavior that caused the condition in the first place, then recurrence should be expected. I have had cortisone shots in multiple joints and have had tremendous success. But at the same time, I realized that overuse caused the injury so I modified my behavior (reduced specific activity) and incorporated physical therapy exercises. I am interested in hearing your thoughts on this. Thanks.

        • I can’t remember about activity levels in that study at this point, but those findings are consistent with more and more studies on the topic. I’m not a big fan of cortisone for it personally, so I might be biased. I worry about what the cortisone does to the tendon, especially with multiple injections. Having said that, many surgeons still advocate it.

    • I was suffering with tennis elbow and decided on the cortisone injection. Within 2 days all pain had gone and stayed that way for 4 weeks. It has now returned worse than ever affecting my sleep and with pain travelling into my shoulder and my grip severely affect at the present time. I am also unable to fully straighten my arm without severe pain. This is now affecting my ability to do simple tasks with my right arm. I would recommend exhausting all other avenues first before jumping in for a quick fix like I did….. Good luck

    • I had an injection 2 days ago. Worse now. No improvement. Severe case. I did it in order to start the eccentric exercises, the only thing proven to really cure the problem, but doing the exercises is incredibly painful. Have had laser, ultrasound, graston, and kinesiotaping. The kinesiotape helps some at least. Definitely worth doing repeatedly. Somehow I’ll have to endure the pain and do the eccentrics. You’d think in 2016 there would be something! It’s impossible to live with the pain and never sleeping due to intense pain at night to boot!

      • I had an injection about 3 months ago for severe pain. It came back and was as bad or worse than before. My 2nd injection was much more painful, only on my 2nd day now, but I don’t see any other options that have good promise. My condition got so bad the first time before the injection I couldn’t pick up my cell phone! I’m a 200 lb man that is very active but never played tennis, and I am now debilitated by this ridiculous disease. No placebo injection could possibly fix my condition, my arm becomes totally worthless without the injection. I am in therapy already for my back pinching nerves so I can’t do therapy on my elbow thanks to the asinine medical insurance policies only allowing treatment of one body part at a time. I was hit by a car on my motorcycle and an going on 6 years of surgeries and repeated physical therapy with no end in sight. This frustrating elbow pain just added to my already overwhelming set of physical problems.

        • ” so I can’t do therapy on my elbow thanks to the asinine medical insurance policies” …. I know this is an old thread but to future readers I’ll add this..I went to therapy for L.E. after receiving the shot. My pain was gone within a couple of days of the injection At the physical therapist, they did nothing there that I could not do at home. After a month of therapy, I was released. Now my l.e. is back. I plan on NOT getting the injection and just doing what I did at therapy before. Is that the correct thing to do??? Well, I’m not sure.

  2. I have a mild/mod case of lateral epicondylitis, I actually do play tennis and experienced a pain upon a topspin forehand in Oct’12. Since then I have been dx and some ROM exercises, kinesiotape, etc. I have not been playing tennis to “rest” it since then and occasionally wearing a cock up splint for wrist extensors to rest during sleep. I just got a cortisone shot and now wonder the best approach? rest for 2 weeks, cont. to not play tennis, yardwork for healing process? If I use it will it not heal but be a nuisance with pain? Dr.s have varied views. I’m an OT and trying to make since of this, I do believe I damaged the tendon(s) playing tennis with possibly poor muscle mechanics, so need to address that. I will be in Charleston in August, maybe an appt?
    Any present suggestions, Thanks

    • It is really difficult to give you any specific advice. Options generally for lateral epicondylitis include a counterforce strap, physical/occupational therapy, and rest from offending activities. If tennis is painful, many patients often give it up temporarily. Cortisone injections are probably not great ideas if patients have already had one and are still having symptoms. Options for the small percentage of people still with symptoms at that point can include PRP or surgery. Also the extent of the damage of the tendon determined by MRI can play a role in deciding the options as well.

      • thank you, in general, what is the recommended protocol post cortisone shot for lateral epicondylitis? 2 weeks after shot and then up to 4 months after shot. what is the recommended time to resume normal activities, though gradually with movement and strengthening exercises? Assuming no pain.
        thanks for this second opinion,
        from a graduate from MUSC

  3. I have had pain, loss of strength not only in my hand but lower and upper arm including pain in the biceps/triceps area and even into the shoulder and armpit area. The physician stated since the lateral epicondyle region was tender he wanted to do an injection and stated that this would rule out if it was true “tennis elbow”. After reading the findings, and undergoing therapy, I am even more hesitant than I was prior to this, of undergoing an injection.
    I’ve had xrays also, and wondering what my next steps should be in the course of treatment, because although my physician seems to think an injection is warranted to “rule out”, I’m not apt to have one. Can an MRI be utilized to rule out other issues or injuries?

    • MRIs can certainly show edema within the tendon that would represent changes related to lateral epicondylitis. They would also show any other changes, such as partial tendon tears. Often treating the pain with conservative measures, such as a counterforce strap or physical therapy, can help determine if that is the diagnosis for a patient.

  4. I have been suffering with lateral epicondylitis for two weeks now I am in absolute agony and can hardly us my arm when I went to the doctors he told me I have tennis elbow, and gave me the cortisone injection, which has made things worse, I can now hardly lift anything. I honestly think that my diagnoses could be wrong. I just want this sorted as its so painful.

  5. I have been carrying this case of golfer’s elbow for about 4 months. I did not want to stop weightlifting so I played through the pain. I only felt pain during triceps and sometimes chest exercises. I used NSAIDs (oral and local) , ice packs to relieve the pain. I also wore an elbow strap to keep pressure on the elbow. I did not stop training though. My condidtion didn’t get better so I decided to go to a doctor.

    The doctor prescribed a more powerful oral NSAID for 2 weeks and complete rest for the upper body. He said if there is no improvement, I will need to take a cortisone shot. I’ve been resting for a week now but don’t feel any improvement. I did some research online and found that many don’t recommend cortisone shots as they do no cure the problem. I am worried it would mask the pain and that I would go back to training full throttle and then injure myself worse.

    What should I do? Fo you recommend I have an MRI scan?

    • I can’t give you specific advice, buy you are correct in that generally I am not big on cortisone shots, for the reasons mentioned in my post. I think physical therapy, counterforce straps, stretching, short-term activity modification and more can be helpful first treatments. I will occasionally do a cortisone shot one time if the other treatments aren’t working, but there are many factors involved.

  6. I have been suffering from tennis elbow on both sides since 5/16/12. I had two sets of cortisone done, first in sept 2012 with great results. I had some initial pain and flare up but the pain was 50-75% better after a month. It lasted a short time, only until late Nov. That is when I received a second set of injections. This time my arm flare was worse, I could not extend my arm fully for week. The pigment is now gone around the site I am left with very indented elbows. The skin is so thin there is nothing left to protect them. On top if these side effects I think the shots made my hair fall out really fast.
    I would not recommend cortisone for tennis elbow as you might end up with irreversible damage. I was recommended to have surgery since it has been well over a yea, and I have tried every thing from arm band, pt, taping, compression sleeves, ice and ultra sound. I also have a back, neck, shoulder and rib that feeds pain down my arms from the nerves. They all contribute to the pain in my arms so I had to have it confirmed via mri before my injections were done. I wish I could go back and not have the injections done. I believe it made things worse in the long run.

  7. I am a Physical Therapist who regularly performs Injection Therapy for Lateral Epicondylitis. I have found that Cortisone injections work well when performed in the early stage of injury and when radiacular symptoms have been ruled out and a confident diagnosis can be made. I think many patients in general practice are wrongly diagnosed. Also, most research studies such as this one look at chronic Lateral Epicondylitis when any inflammatory stage is well past and tendons are in a degenerative state. In these cases, its no surprise there is no long term benefit. I would like to see a study where cortisone is performed in the acute stage of injury and look at the long term effects of this.

  8. I have golfers elbow in my right arm and tennis elbow in my left arm I have had this problem for well over a year now I have had about 4 cortisone injections in my left arm which is pain free at the moment however I have had about 6 injections in my right arm my arm is still in a lot of pain I asked the doctor are you supposed to have this many and he said well it will help I have heard that you should only have 3 I wonder is this going to damage my tendons because it does not seem to be helping I have lost a lot of grip in my hand I cannot put any pressure on with my hand at all

  9. I have a partial rotator cuff tear with my primary symptoms being bicep tendonitis. I’ve been given contradictory advice that cortisone injections would either mask symptoms as you stated or others stating injections would help with inflammation long enough for me to strengthen the area to avoid the need for surgery later. I definitely don’t want to do something that will weaken the area in the long term by exasperating the problem through exercises that may actually make the situation worse. Physical therapy hasn’t helped and I’m not a candidate for surgery yet according to doctors who looked at my MRI. Any ideas? Thank you ahead of time for your insights.

    • This post and the thoughts about cortisone injections pertain specifically to tennis elbow (lateral epicondylitis). It is potentially an option for some patients with shoulder issues along with other nonoperative treatments. It might be a question appropriate for your orthopaedic surgeon to help find treatments appropriate for your particular problem.

  10. I had lateral epicondyle release with partial ostectomy on both arms after undergoing PT and cortisone injections. I had 3 injections in right arm with minimal relief and 1 injection in left arm with no relief in a span of 1 year. I have a job that is very repetitive and my concern is that if I go back to it am I going to be in the same shape before the surgery’s. I can not modify the way I do my job. Any suggestions?

    • Honestly I don’t have any specific suggestions since I am not involved in your care. Generally if a patient works hard to let the surgery heal and regain motion and strength, he can return to his former activities.

  11. I had shot April 2013. Shot was effective for 2 months. Pain came back. Got another shot 2 weeks ago. The shot did not work. I can’t use my arm. I have no strength. it hurts to even move my fingers. My whole arm is effected. I take anti inflammatories on a daily basis and the pain still persisting. My injury happened on the job in December of last year. I went to the Kaiser the doctor said if I still have pain come back in two weeks. So I did, went back and they did nothing. Then in April I finally got the shot. And I just had another one two weeks later. I think something else is wrong.

  12. I have made a living as a potter for 35 years, and the last few years have suffered with left lateral epicondylitis – made worse I believe, by a torn right rotator cuff 3 years ago. Last spring I had the cortisone injection, which I found incredibly and brutally painful for the first week. After it settled down, it was wonderful for about 5 months. In October, while working hard as ever, I literally felt it “go” again. I am opposed to ever receiving another cortisone injection, so I met with a surgeon in December to discuss lateral epicondyle release. Everything I’ve read tells me that 80% – 90% of patients with epicondylitis can recover without the surgery. I have tried to rest it, and not worked since November, but it doesn’t seem to be much better. The strap that I wore for about 6 weeks only made it feel worse, and for the last month or so, I am wearing the “Futuro Infinity” brace, which provides minimal comfort. As it has been 4 months now, I am agonizing over whether to do the surgery, or just hope the elbow heals sooner rather than later. I would appreciated your advice on this matter.

    • It sounds like you have tried many of the nonoperative options for lateral epicondylitis. Some patient try PRP for chronic tendinopathy. Physical therapy can help many patients. Surgery can be an option if nothing works. I can’t give you advice on what you should do, though.

  13. I had a cortisone shot on friday for “tennis elow” it did not help the slightest bit. infact things are way worse. before the sot I could marginally use my arm, with pain but bearable. since the shot I can do nothing. I cannot straighten my arm or even hold a pen 🙁 please avise what other options there are?

    • I can’t say without being involved in your care. You might contact your orthopaedic surgeon for advice.

  14. I was having pain in my elbow from march this year, till now, had the shot on my elbow 3 days ago, but after the shot i felt the heavy in my whole arm, now i cant even straighten my arm or move it around,It is so painful that i couldnt even comb my hair nor touch it, omg this is so painful:(

  15. I have been suffering from tennis elbow since April of this year. I am an IT Desktop Analyst so I am hauling and setting computer equipment as well as typing on a daily basis. I have been seeing a hand therapist now for 6 sessions with no relief at all. Going through several different exercises, icing, using a couple different braces as well as kinesio tape with no relief from the pain at all. Even with resting it, my arm is still extremely painful with severe burning. I have heard about cortisone shots not being a good option as they only provide temporary relief, but I’m at a loss as far as what my next options are. I struggle with my daily routine getting ready in the morning as well as doing my job. Please help!

    • Physical therapy with or without modalities, home exercises, use of a counterforce strap, platelet-rich plasma, and surgery can all be options in place of or along with a cortisone injection for patients with lateral epicondylitis..

  16. After having type 1 diabetes and given birth 10 months ago I some how got tennis elbow in my left arm 5 months ago, the pain was to the point where I couldn’t take it anymore and was advised by my GP to have the cortisone injection, upon getting an ultrasound the GP showed me the area that had information while at the same time as the injection (owch). Following tht I had a lot of pain not just in the area of injection but my whole arm was and has been aching since, it’s been 2 days now and I feel that it’s much worse than before. I was shocked to read that cortisone injection ha such crap results, any advice on what my next step is?

    • I really can’t offer specific medical advice on this site. You might discuss options with your orthopaedic surgeon.

  17. I have had tennis elbow for 7 months (since Dec 2013) with a knot at the outside tip of my elbow . I have treated with NSAIDS, had a cortisone shot in March, another in May, and am now doing OT for the last week. The therapy seems to be making it worse so far – my question is whether or not this is a normal course for this condition. Not sure where things are going, but it is becoming a big nuisance to just do things I need to do around the house. What’s next?

    • You might discuss your case with your orthopaedic surgeon to determine next steps, like PRP injections, brace and surgery.

  18. I had completely successful surgery on my right elbow in 2008 after a two year bout with PT, and cortisone shots. Same issues with left elbow a couple of years ago. Had cortisone shots, and finally surgery in April. However, the surgery provided no relief, I am in more pain now than before. I feel he either fixed what wasn’t broken, or there was something else involved. He is a nationally recognized surgeon, so I feel confident in his ability, but now I’m wondering what could come next (I now have to back next week to see him). Do you recommend getting a scan or something? Thanks!

    • That is probably a better question for the surgeon, as he can tell if the chances that there is something else going on, like nerve entrapment from radial tunnel syndrome or some other diagnosis. Good luck!

  19. I had surgery in March of 2013 after a year and half of suffering in severe pain, 3 steroid injections, acupuncture and physical therapy for 8 months.
    This week I will be having an EMG study done as I am still in severe pain with burning and needle shocks up my arm and wrist.
    My question is if this EMG study comes out normal, what would be the next step. I do see my orthopedic surgeon next week after the test. Thank you for your assistance.

    • It is hard to say without being involved, but people with lateral epicondylitis who fail nonoperative treatments can be a candidate for surgical treatment.

  20. I had three injections in my right elbow last year. No pain just pressure while being given. I got first injection in left elbow yesterday, there was a lot of pain while being injected. no pain for about half hour after. I am in more pain now than before the shot. My question is can this injection make it impossible to bend towards your chest? I have not been able to and I have lots of pain with any bump of my elbow or hand.
    I am able to bend and straighten my fingers just can’t grip anything. Please any info is appreciated.

  21. I just received my 3rd Cortisone injection for Epicondylitis today. I was given the option of the cortisone injection,physical therapy or surgery. The second injection lasted for several months,but then the pain came back. I couldn’t grip or lift anything with my left hand. I am not sure what to do next if the last injection doesn’t help.

  22. I have bi-lateral tennis elbow and I have had 12 cortisone injections, 2 blood injections and 2 tendon releases and still have trouble with both arms, my arms are very weak and painful whenever I have to use them. The drs are great believer’s in cortisone shots but fail to tell you that they are only a band-aid. I also suffer now from a bursa in the right shoulder with an impingement, which is moving my shoulder out of place. I have just read about microcurrent therapy, has anyone had or heard of this?

  23. I had work injury since Nov 2014, but it was only in April when MRI was ordered, and results are: moderate common extensor tendinopathy with linear interstitial tear of 11 mm, mild chondromalacia, and mild ulnar nerve edema- localized neuritis. I am undergoing hand therapy with lateral epicondylitis exercises and ulnar nerve glides. My therapist recommend cortisone injections, which I am hesitant due to the bad effects it will cause. With my diagnosis, would you recommend surgery? If so, can the surgery be done one time for both ulnar nerve and lateral epicondylitis? If I opt not to have surgery yet, will the tendon tear heal by itself? I am worried coz it’s taking so long to heal, I am wearing my counterforce brace and also splint at night (for ulnar nerve). I would appreciate if you can give me some advise on what options I have. Thank you.

    • I can’t give you advice on what you should do, so I’d ask your orthopaedic surgeon. Generally a surgeon could treat the ulnar nerve and extensor tendon in the same surgery.

  24. My first injection into my elbow was administered by my doctor. The pain left for two months. Relief occurred within a day or two; however, I had a visit yesterday, and either a nurse or physician’s assistance administered the injection after the doctor came in and asked if I wanted to receive another injection. (He only will try these injections 1 to 3 times. I said, “yes,” because I had such good success & hardly felt the shot previously. This time one of his employees gave me the injection. Not only did it hurt, but my elbow swelled, was bruised, & my pain is much worse. I used an ice pack before I went to bed, and now I am not in good shape with the elbow. I have just take ibuprofen, and am going back to bed. I pray that the pain subsides when I arise tomorrow. I am very disappointed. I guess I should have requested that my doctor administer the injection.

  25. Could my mri miss things. I had one after 6 months of constant pain. was told the mri was negative for any tears but showed inflammation. I was already so limited on my range of motion that I could not raise left arm to head or lift anything even a cup of coffee was painful. Doc gave me an injection after negative mri and it is 100 times worse now. That was yesterday. I am a tough cookie and am in tears.
    I had a tear in right elbow three years ago that they had me suffer for over a year before they did surgery which corrected the pain , this pain started much the same and now it is ten times worse that the right was but yet they said no tears noted on mri.. God help me I am in horrible pain never felt this horrible pain.
    I had a car wreck two years ago and suffered soreness in it after that for months then it got feeling mostly better then it just started suddenly one day and has gotten worse daily. But after injection it is not stopping hurting. I admit he had a time doing the injection as I have had them before and this time he had to move and turn the needle inside the elbow several times. Not pulling it out just while in it already and I thought i was going to scream. within 5-10 minutes the horrible pain started and I have not ever felt this hurt from my fingers and wrist to my shoulder. HELP

  26. Firstly…thanks so much for taking the time to field questions on this topic. I know your original post is a couple years old but my hopes are that you’re still amenable to continuing to field questions.
    So I have had two nasty bouts with lat epicondylosis…the second of which is far worse than the first and still ongoing. I get my issues from whitewater kayaking which requires an immense amount of complex, compound wrist/elbow joint movements. The first bout convalesced spontaneously and required 3 things….rest, rest and more rest. The second/current bout is going horribly badly. I started resting it completely to no avail so then i went to PT for about a month (3ish times/week) but still no results. Of note with this bout is that about a week after I started noticing a little pain and stiffness in the elbow, I was paddling and I felt a distinct pop in the elbow while doing an eskimo roll and then immense pain. It eventually settled into a state that felt similar to the pain/stiffness I felt in the fist bout but the major difference is that it just feels stalled out in its recovery….like it may just never get back to normal. It’s been about 8mos since this offending injury.
    So my question is two-part….what course of action should I take at this point….more rest…more PT…corticosteroid injection…MRI…surgical consult??? And further to that point…if I ever do get this elbow healed up, what can i do to prevent a recurrence of this…other than quitting paddling altogether (which isn’t really an option in my book)?? Are certain stretches recommended to strengthen this area??

    Thanks in advance for your help!

    • I know they can cut the tendon, reattach it and drill small holes in the bone to get more blood to the worn out tendon. That’s what I’m looking at if the shot fails we’ve tried everything else months of therapy, weeks of rest it’s still annoying. 😈👽👺🙀

  27. I was very interested in your thoughts and observations about tennis elbow. The article was helpful about the shots, but it really didn’t offer information beyond that, such as alternative options. It’s great that your sharing the downside of the injections, but it would have been beneficial to those of us reading it to learn what other suggestions or options are available.

  28. I’m a groomer so continually using my right arm, it’s my business so I can’t just quit and I can’t really rest it. My chiropractor gave me some stretches to do and showed me how to use my sensor points it helped foe a while so I went to my GP who said I had golfers and tennis elbow he has given me the steroid injection in 2 places first few days it felt like heaven now 5 days later I’m getting shooting pins and needles from my elbow down to in my fingers is this normal?

  29. I have been told by my doctor I have shoulder impinchment I have had it for about 2years and it as gone into my other shoulder and back and neck and I’m having problems with my groin to its very painful when I walk or put any pressure on it and it as all started when I had my cortisone injection

  30. Great piece, thank you for opening my eyes to this. I had two cortisone injections in my golfer’s elbow around a year ago, is there anything you can do to reverse the negative impact the injections had on my injury? The first one didn’t make any difference, the second gave me a month of pain free tennis before coming back worse than ever.

  31. As a pharmacist I have been in practice since 1953. I don’t remember a single case, where a tennis-
    elbow strap around the arm at the area where the muscle tendon attaches to the bone, where the
    individual did not get relief. Since our pharmacy was next door to a physical therapist this particular
    event happened frequently/. Therapists even use acupuncture unsuccessfully for tennis elbow,

  32. Further to my Tennis Elbow comment ====== the reason the Tennis Elbow Strap
    works is because the Strap takes the tension off the point where the arm muscle
    tendon attaches to the bone. The name “Tennis Elbow” gets its name from the
    tennis players snd golfers who can through “over use” get this condition. You often
    see tennis players and golfers wear this strap.By using this strap you give the tendon
    junction a time to heal. Caution: Don’t put the strap over the elbow!

  33. I have no pain or difficulty in my elbow but lots in the lower bicep and upper forearm. Doc said it was tennis elbow and put me on Naproxen for 2 months. This has not helped at all and weakness in the arm has gotten so bad I can just pick up a half glass of water. I am now scheduled for an injection but have my concerns as to whether this is the right route to go down. Reading these comments I feel I should have an mri first to establish if it’s tennis elbow or something else. I would hate to have the injection just to regret it later as some comments state

  34. I have had tennis elbow for about 30 years. I did long term physical therapy with no success and have had many cortisone injections. Mostly they did work for about 3 months and the pain would return. I also used the strap and I had no relief. I had an injection just about three weeks ago and it lasted for 4-5 days than came back with a vengeance. I now have a lump over the joint and I don’t know what to do about it. I pain is so bad that it brings tears and sometimes just makes me cry. Any suggestions?

  35. Very interesting read Dr Geier , and so many views . Approx 27 years ago I had 5 steroid injections in my shoulder . In the end I saw a wonderful OP surgeon in London . He knew straight away what my injury was ( sports related) . Said all the cortisone would never have helped me, I had tore my tendons/ligaments/ dislocation . He was disappointed for me, at my wrong diagnosis. Long story short , 5 years of pain . Acromion removed . No pain from that day. Even the surgery was less painful. I am very grateful continued with all my sports. However I still do have Injections time to time if I have an injury .

  36. I’ve had tennis elbow in my left elbow and tennis in my right. I’ve received cortisone shots in both for 2 years now. Every 3 months then gradually every month and half. It’s caused from continuously lifting in my job. I’ve left that job hoping it would subside. Well it’s worse because I can’t afford anymore shots due to no insurance. I won’t have insurance until July. Any suggestions on how I can cope?

  37. I think a key point here is in the healing process. If Cortisone is more a pain relief then in essence it is not promoting healing. Would it be better to look at injections with a medicine to promote the healing process? Also, if this is an option what kind of medicinal injectables are available?

  38. Hi, I’ve recently had cortisone injections in both elbows, for golf elbow, 2 days later and have pain in my forearm, radiating to upper arm and my neck, wondering if its related?….also I do a repetitive job, its constant squeezing hand and arm bending for 10 hour shifts, my doctor says I am able to resume normal duties, is this true even though my normal duties caused this, surely it will either make things worse or result in more injections, have been doing the same job for 20 years, so think maybe the damage is worse than what appears

  39. I had tennis elbow in my left arm a few years ago. I tried a cortisone shot and it helped for about 6 months. I can’t remember exactly but I might of had one more before having surgery. The surgery was a success and have been pain free in that elbow for about three years now. Unfortunately though, within a year I started having the same symptoms and pain in my right elbow. I’ve had at least two shots and they last almost exactly 6 months. I’m going to get one more today with the hopes of it lasting another 6 months and then just get the surgery. I’d rather be in a cast in the middle of winter than the summer. So my point is, based on my experience, the shot provides relief from the pain so you can function. If it doesn’t heal within a year (given that a person has changed their routines that may have caused it and added some type of PT), the surgery, being the last resort, works. I think my arm was in a soft cast for about 7 days, removed it and the stitches, and then in a hard cast for about a month. Followed that with PT for an hour a few days a week for about two weeks (this was mainly to build strength and to get my arm to fully extend). Give it a couple months to regain the strength you previous had. I started going though all this about two years after retiring from the Army in which my physical demands decreased by 70% or more.

  40. I had steroid injection 4 weeks ago for golfers elbow . The pain durning it to now is horrendous . Trying to straighten it is so bad . Told doctor at the time just kept putting more anistetic in . Feels like bone is chipped . Bad to rest on or touch

  41. I had a steroid injection for this, was first line of’s been at least 5 yrs.ago,has never recurred.Was great for me.

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david-headshot I am an orthopaedic surgeon and sports medicine specialist in Charleston, South Carolina.

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