Should I Get a Steroid Injection for Tennis Elbow?

Should I Get a Steroid Injection for Tennis Elbow?

Effective short-term but not recommended long-term. Tennis elbow is not “inflammation” but tendon “degeneration.” Steroid injections reduce pain for 1-2 weeks but interfere with collagen synthesis, making tissue weaker long-term.

Tennis Elbow Is Not “Inflammation”

Histological Research Findings

Under microscope, chronic tennis elbow tissue shows the following.

  • Inflammatory cells: Rarely found
  • Actual tissue appearance. It shows excessive fibroblast proliferation, disorganized blood vessel formation, and degenerated collagen structure

This is called “tendinosis,” the result of chronic load-management failure.

Effects and Limitations of Steroid Injections

Timeline Effect Side Effects
1-2 Weeks Pain significantly reduced –
4-6 Weeks Pain returns Tendon collagen synthesis begins to decline
3-6 Months Pain worse than before injection Tendon tissue weakened, higher recurrence rate
1 Year Later Worse than non-injection group Accelerated tendon degeneration, chronification

Research Results

In a 1-year follow-up study, the steroid injection group had much higher recurrence rates than the non-injection group, and tendon tissue was weaker long-term.

Why Steroids Weaken Tendons

1. Reduced Collagen Synthesis

Interferes with collagen production that forms tendons, decreasing tendon strength.

2. Suppressed Fibroblast Activity

Inhibits activity of cells that repair tendons, reducing recovery capacity.

3. Impaired Blood Vessel Formation

Blocks blood vessel formation that supplies nutrients and oxygen to tendons, delaying healing.

Then How Should It Be Treated?

In tendinosis, treatment requires appropriate mechanical stimulation to realign collagen structure.

1

Calm

Use Circulation HD to release adhesions around tendons and relieve excessive tension.

2

Wake

Gradually apply appropriate load to tendons through isometric exercises, progressing to eccentric exercises.

3

Make it stick

Assess the kinetic chain to identify factors that may contribute to elbow overload.

Circulation Therapy That Strengthens Tendons

Not eliminating inflammation, but fundamentally restoring tendons.

  • Circulation HD:
    • Release adhesions at tendon attachment sites
    • Improve blood circulation (restore nutrient supply)
    • Reduce nerve sensitivity
  • Circulation PT:
    • Progressive isometric and eccentric exercise stages
    • Kinetic chain recovery (core, thoracic spine, scapula)
    • Shock absorption capacity training

Related Questions

References

  • Coombes BK et al. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy. Lancet. 2010;376(9754):1751-1767. PMID 20970844
  • Bisset L et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006;333(7575):939.
  • Smidt N et al. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet. 2002;359(9307):657-662.
  • Gaujoux-Viala C et al. Efficacy and safety of steroid injections for shoulder and elbow tendonitis: a meta-analysis of randomised controlled trials. Ann Rheum Dis. 2009;68(12):1843-1849. PMID 19054817

Want to Fundamentally Treat Tennis Elbow?

Try Circulation Therapy that strengthens tendons.

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