Corticosteroid injection in early treatment of lateral epicondylitis

Clin J Sport Med. 2001 Oct;11(4):214-22. doi: 10.1097/00042752-200110000-00002.


Objective: To analyze whether a corticosteroid injection in combination with rehabilitation early in the course of lateral epicondylitis (LE) alters the outcome up to 6 months after injection compared with a control injection and rehabilitation.

Design: Randomized, controlled, double-blind study.

Setting: Sports medicine center in a tertiary care center.

Participants: Subjects with a diagnosis of LE whose symptoms had been present less than 4 weeks were included. Subjects were recruited by word of mouth and through advertising. The 39 subjects who were recruited were 18 to 65 years old.

Interventions: 19 subjects were randomized to receive rehabilitation and a sham injection, and 20 were randomized to receive rehabilitation and a corticosteroid injection. At 4 and 8 weeks, they were reevaluated and their treatment programs were modified, if indicated.

Main outcome measures: Outcome measurements were performed at baseline, 4 weeks, 8 weeks, and 6 months, and included a functional pain questionnaire and a visual analogue pain scale. Painless grip strength on the affected side and maximal grip strength bilaterally were measured at baseline, 4 weeks, and 8 weeks.

Results: There were no significant differences in outcome between the two groups with the exception of an improvement in the visual analogue pain scale in the corticosteroid group from 8 weeks to 6 months. Outcome measurements in both groups improved significantly over time; more than 80% of subjects reported improvements from baseline to 6 months for all scales.

Conclusion: A corticosteroid injection does not provide a clinically significant improvement in the outcome of LE, and rehabilitation should be the first line of treatment in patients with a short duration of symptoms.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anesthetics, Local / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage*
  • Athletic Injuries / drug therapy*
  • Athletic Injuries / rehabilitation
  • Betamethasone / administration & dosage*
  • Bupivacaine / administration & dosage
  • Cryotherapy / methods
  • Double-Blind Method
  • Exercise Therapy / methods
  • Female
  • Functional Laterality
  • Hand Strength
  • Humans
  • Injections, Intramuscular
  • Injections, Subcutaneous
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Tennis Elbow / drug therapy*
  • Tennis Elbow / rehabilitation
  • Time
  • Treatment Outcome


  • Anesthetics, Local
  • Anti-Inflammatory Agents
  • Betamethasone
  • Bupivacaine