The results of a recent study (Coombes, 2013) are very interesting when it comes to clinical decision making in the treatment of lateral epicondylalgia (tennis elbow). This was a large RCT looking at those with clinical signs and symptoms of LE, without evidence of cervical/ neural involvement. The participants were randomised into four groups and received either cortisone injection only, cortisone with physiotherapy, placebo injection only, and placebo injection with physiotherapy. I have summarised the results as follows.
Those who had cortisone injections achieved some short term pain relief but at 12 months they are less likely to have recovered completely or be much improved, there is also a high recurrence rate at 24 month follow up. This did not change when physiotherapy was added.