What is the long-term efficacy of corticosteroid injection compared to autologous blood injection, or extracorporeal shock wave therapy (ESWT) for lateral epicondylitis (tennis elbow)?

Updated: Oct 30, 2018
  • Author: Bryant James Walrod, MD; Chief Editor: Craig C Young, MD  more...
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Answer

In 2010, Ozturan et al performed a 3-armed randomized trial of 60 patients with symptoms consistent with lateral epicondylitis for greater than 6 months with no previous physical therapy in the past 3 months to a corticosteroid injection, autologous blood injection, or extracorporeal shock wave therapy (ESWT). [27] Outcomes measured were Thomsen provocative test scores, upper extremity functional scores, and maximal grip strength. Assessment was at 4, 12, 26, and 52 weeks. Sixteen of the 20 patients in the autologous blood group received a second injection at 6 weeks.

In this study, at 4 weeks, the corticosteroid group had a significant improvement in a functional score and Thomsen provocative tests over both the autologous blood group and the ESWT group. There was no difference between the autologous blood group and the ESWT at 4 weeks. There was no significant difference in these tests at the 12-week mark. Following patterns from other studies, the corticosteroid group performed less well the longer that the patients were followed. There was a statistically significant improvement for the autologous blood and ESWT groups compared with the corticosteroid groups at the 26- and 52-week follow-up appointments for functional scores and Thomsen provocative tests.


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