There is no proved treatment

We in the hospital service are constantly told that it is more efficient to retain patients in primary care, but most of Mallen and colleagues’ 10-minute consultation on tennis elbow was flannel.1 And what did the patient get out of it at the end? Nothing really. Tennis elbow is diagnosed following a complaint of persistent pain at the lateral epicondyle and is confirmed by focal tenderness 1 cm distal to the bony prominence. There is no proved treatment, and the condition settles after about a year. Usually it is fatuous to tell patients to “avoid” certain actions because they have to get on with their lives and pain will dictate what they can and cannot do.

Steroids achieve nothing.2 Indeed, if you believe the microtrauma theory, then to subject patients to “pepperpot” injections at the site is nonsense: anyone who has done appreciable amounts of minor surgery will know the degree of bruising and bleeding in local tissues caused by injections.