Corticosteroid and platelet-rich plasma injection therapy in tennis elbow (lateral epicondylalgia): a survey of current U.K. specialist practice and a call for clinical guidelines

Br J Sports Med. 2015 Nov;49(21):1410-3. doi: 10.1136/bjsports-2013-092674. Epub 2013 Nov 6.

Abstract

Background: Tennis elbow is a common condition with a variety of treatment options, but little is known about which of these options specialists choose most commonly. Corticosteroid injections in tennis elbow may reduce pain in the short-term but delay long-term recovery. We have undertaken a UK-wide survey of upper limb specialists to assess current practice.

Methods: Cross-sectional electronic survey of current members of the British Elbow and Shoulder Society (BESS) and the British Society for Surgery of the Hand (BSSH).

Results: 271 of 1047 eligible members responded (25.9%); consultant surgeons constituted the largest group (232/271, 85%). 131 respondents (48%) use corticosteroid injections as their first-line treatment for tennis elbow. 206 respondents (77%) believed that corticosteroid injections are not potentially harmful in the treatment of tennis elbow, while 31 (11%) did not use them in their current practice. In light of recent evidence of the potential harmful effects of corticosteroid therapy, 136 (50%) had not changed their practice while 108 (40.1%) had reduced or discontinued their use. 43 respondents (16%) reported having used platelet-rich plasma injections.

Conclusions: Recent high-quality evidence that corticosteroids may delay recovery in tennis elbow appears to have had a limited effect on current practice. Treatment is not uniform among specialists and a proportion of them use platelet-rich plasma injections.

Keywords: Tendons.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Humans
  • Injections
  • Platelet-Rich Plasma*
  • Practice Patterns, Physicians'*
  • Sports Medicine*
  • Surveys and Questionnaires
  • Tennis Elbow / therapy*
  • Treatment Outcome
  • United Kingdom

Substances

  • Adrenal Cortex Hormones