23/10/2026
Short term effects over long term issues, ask the question before looking at injections of cortisone
Corticosteroid injections are the intervention I want to address most directly, because they remain commonly offered and the evidence against them, particularly for long-term outcomes, is consistent and compelling. Cortisone injections for tennis elbow should be avoided in most cases. Let me explain…
A well-designed RCT published in JAMA found that while corticosteroid injections provided superior short-term pain relief at six weeks compared to physiotherapy and watchful waiting, by 12 months the injection group had significantly worse outcomes than both other groups, with higher recurrence rates (Coombes et al. 2013). Short-term relief followed by long-term recurrence and potentially worse tendon biology is not a trade worth making for a condition that resolves on its own. I recommend avoiding corticosteroid injections for this problem.
PRP (platelet-rich plasma) injections are a different conversation — the evidence is more nuanced, and certain PRP preparations may have a role in recalcitrant cases. If you are considering PRP, understand that not all PRP is equal. Preparation technique, platelet concentration, and injection protocols all matter.
This is a discussion to have with a physician experienced in PRP for tendinopathy.
