Periarticular soft tissue rheumatic complaints include localised disorders of tendons, ligaments, muscles, fascia, and joint capsules. Such complaints account for up to 59% of new patient referrals to a rheumatology practice1 and up to 15% of consultations in primary care.2 Tendon lesions (tendinopathies) represent a large proportion of these complaints and are often the most difficult to treat. Their high incidence of chronicity and recurrence 3 4 result in appreciable morbidity and loss of productivity, representing a major socioeconomic burden.5

Corticosteroid injections are one of the most commonly used treatments for chronic tendon lesions.1 Despite their popularity, the rationale for use of corticosteroid injections is contentious, the evidence for benefit is lacking, and they have potential adverse effects. This article describes the nature of tendon lesions, the basis for the use of local corticosteroids, and current evidence for beneficial and adverse effects.