Although cortisone injections provide short-term pain relief from tendon injuries such as tennis elbow, their use produces worse long-term results than other treatments — or no treatment at all.
So concludes a new study that analyzed 41 previously published reports over the past three decades on the use of various treatments on nearly 2,700 patients with tendon injuries — such as tennis elbow, rotator cuff injuries and aching Achilles — where tendons become painful or torn, often from overuse.
The study's take-home message on the use of popular corticosteroid injections: Expect "short-term gain but long-term pain," lead author Bill Vicenzino of the University of Queensland, Australia, tells the Bulletin. "These injections have a high chance of success within three to six weeks." But six to 12 months after injection, patients in those studies had a 62 percent higher risk of relapse than those who initially did nothing, adopting a "wait-and-see" approach. And cortisone proved no better for tendon injuries than non-steroid-based treatments such as Botox, platelet-rich plasma and sodium hyaluronate.
The review study, published in the Lancet, did not analyze how age impacts injury relapse in those getting cortisone shots, a powerful anti-inflammatory. But tendinopathy "is generally a condition of middle age," notes Vicenzino, a professor of sports physiotherapy. "For example, tennis elbow occurs on average at age 45" and can last well into the 50s and 60s.