Steroid Injections – Long Term Effect

This article appeared in the Science Section of yesterday New York Times. It certainly made me think of all the steroid injections I have seen during my involvement in sport. Sort term gain, for long tern loss, unfortunately in professional and high level collegiate sport this goes on all the time.

“Treatment: Tennis Elbow, Advice: Spare the Steroid Injections

Steroid injections for tennis elbow are largely ineffective in the long run, a new study has found. Australian researchers randomly placed 198 people with tennis elbow, ages 18 to 65, in one of three groups: the first received eight 30-minute physiotherapy treatments over six weeks, the second received a corticosteroid injection (with a second injection a week later if deemed necessary) and those in the third were told to wait and see how the injury healed while using analgesic drugs and avoiding activity that would aggravate their pain.

The study appears in the Online First edition of The British Medical Journal. The group that received the injections showed significantly better effects at six weeks than the other two groups, but the recurrence rate thereafter was 47 of 65 subjects, or more than 72 percent. Recurrence rates for physiotherapy and for wait-and-see were less than 9 percent.

“Most people ask about an injection,” said Bill Vicenzino of the University of Queensland, the lead author of the study. “I tell them that in the short term it may be helpful, but there’s a high probability of recurrence, and the long-term outcome is not that great. Based on a number of studies, I would recommend avoiding corticosteroid injections entirely for tennis elbow.”

After one year, 90 percent of the wait-and-see group rated themselves as either much improved or completely recovered. So did 94 percent of those who received physiotherapy. But only 68 percent of those who received an injection thought they were that much better a year later.”