Corticosteroid Injections for Tennis Elbow

The male patient visitng doctor for shot inoculation


Corticosteroids (CSI) are very powerful anti-inflammatory drugs. CSI treatment involves injecting a small amount of corticosteroid, often with some numbing medication, into the area of where the tendon inserts onto the lateral epicondyle. The idea is to reduce the load on the extensor tendon to give it a chance to heal.



RESCU Treatment Ratings

R = Risk      E = Effectiveness      S = Self-Care

C = Cost     U = Usefulness (overall rating)

1 = Least Favorable     5 = Most Favorable


RISK: 2/5


Steroid injections have some risks. They can cause increased pain and swelling in the area of injection. Cortisone reduces the body’s ability to fight infection, and it is always possible the injection itself can introduce infection.

Some people can have an allergic reaction to the ingredients, and diabetics always need to be careful about corticosteroid injections as it can significantly increase blood sugar levels. In addition, some studies have indicated that injections can increase the risk of tendon rupture. Also, some patients, especially those with darker skin, may experience skin discoloration or lightening.  

Some studies have indicated that corticosteroid injection can cause long-term degeneration of tendons. While the risk of complications is low, they are nevertheless real and potentially serious.


Smidt N, van der Windt DA, Assendelft W, et al. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomized controlled trial. Lancet. 2002 Feb 23;359(9307):657-662.

Bisset L, Smidt N, Van der Windt DA, et al. Conservative treatments for tennis elbow do subgroups of patients respond differently? Rheumatology (Oxford). 2007;46(10):1601-1605.