RECOMMANDATIONS:

The evidence indicates that steroid injections are effective in the short term (< 6 weeks) for reducing pain and improving function in patients with lateral epicondylitis (Level A Recommendation).
• The evidence indicates that steroid injections are not effective in the intermediate and longer term (> 6 weeks) for reducing pain and improving function in patients with lateral epicondylitis (Level A Recommendation).
• The evidence indicates that physiotherapy interventions including general active physiotherapy, exercises and iontophoresis were more effective than steroid injections in the intermediate to long term (Level A Recommendation based on 1x HQ SR, 1x AQ SR and 2x AQ RCT)
• The evidence indicates that autologous blood product injections are more effective than steroid injections, particularly in the long term (Level A Recommendation based on 1x HQ SR, 1x AQ SR
• The evidence indicates that platelet-rich plasma (PRP) appears to provide better longer term pain relief than steroid injections (Level C Recommendation based on 2 x AQ RCT (AQ+))
• The evidence indicates that steroid injections are effective in the short term (< 8 weeks) for reducing pain and improving function in patients with medial epicondylitis. (Level C Recommendation based on 2 x AQ RCT (AQ+))
• Minor complications associated with steroid injections into the elbow are not uncommon but rarely require significant medical attention. Prevalence rates of minor complications associated with steroid injections appeared no different than following placebo injections. (Level A Recommendation based on 2 x SRs)
• The evidence suggests that steroid injections present a much smaller portion of direct medical spending related to treatment of lateral epicondylitis than physiotherapy, GP visits and specialist visits (Level D Recommendation based on 1 cohort study)
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