Double Fault: No Long-Term Benefit of Corticosteroid Injection or PT for Tennis Elbow

Lateral epicondylalgia (tennis elbow) often is managed with corticosteroid injections, physical therapy (PT), or both, despite contradictory and predominantly negative results of mostly small studies. Now, Australian researchers randomized 165 patients with unilateral tennis elbow to single injections of corticosteroid plus local anesthetic (10-mg triamcinolone acetonide plus 1-mL 1% lidocaine) or placebo (isotonic saline), with each group further randomized to PT (eight 30-minute sessions for 8 weeks) or no PT. Adherence and follow-up were nearly perfect.

The primary outcome of complete recovery or much improvement at 1 year significantly favored placebo over corticosteroid injection (96% vs. 83%), with or without PT. Likelihood of this lon…