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Letters Tennis elbow

Injecting steroids is not good

BMJ 2009; 339 doi: (Published 09 December 2009) Cite this as: BMJ 2009;339:b5319
  1. Ray F O’Connor, general practitioner and assistant programme director1
  1. 1Mid-West Specialist GP Training Scheme, University of Limerick, Limerick City, Republic of Ireland
  1. rocthedoc{at}

    Mallen and colleagues seem to advocate routine local injection for tennis elbow.1 However, I have long been struck in my practice by the clinically significant recurrence rates of the condition after corticosteroid injection.

    Indeed, Bisset et al concluded in the BMJ in 2006: “The significant short term benefits of corticosteroid injection are paradoxically reversed after six weeks, with high recurrence rates, implying that this treatment should be used with caution in the management of tennis elbow.”2

    I changed my clinical practice as a result and no longer inject tennis elbow. Alternative management policies are wait and see in the first instance, and physiotherapy combining elbow manipulation and exercise in the case of persistent pain.


    Cite this as: BMJ 2009;339:b5319


    • Competing interests: None declared.


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