tennis elbow is a diagnostic term that describes a pattern of pain and localized tenderness at the lateral epicondyle of the distal humerus . the anatomic basis of the injury to the extensor carpi radialis brevis ( ecrb ) origin appears to be multifaceted , involving hypovascular zones , eccentric tendon stresses , and a macroscopic degenerative response . although many treatments have been advocated , this article discusses the treatment of steroid injection for lateral epicondylitis and documents a review of the medical literature . tennis elbow was first described in 1883 by major   as a condition causing lateral elbow pain in tennis players . over the years , this term has become synonymous with all lateral elbow pain , despite the fact that the condition is most often work - related and many patients who have this condition do not play tennis . it has been estimated , however , that 1050% of people who regularly play tennis will develop the condition at some time during their careers . a recent study on biomechanics demonstrated that the eccentric contractions of the ecrb muscle during backhand tennis swings , especially in novice players , are the likely cause of repetitive microtrauma that causes tears in the tendon and lateral epicondylitis . some others suggested causes of tennis elbow , or lateral epicondylitis , are trauma to the lateral region of the elbow , relative hypovascularity of the region , and fluoroquinolone antibiotics . lateral epicondylitis occurs much more frequently than medial - sided elbow pain , with ratios reportedly ranging from 4:1 to 7:1 [ 7 , 8 ] . in the general population , the incidence is equal among men and women , and in tennis players , male players are more often affected than female players . the average age of the patient who has lateral epicondylitis is 42  years old , with a bimodal distribution among the general population . an acute onset of symptoms occurs more often in young athletes , and chronic , recalcitrant symptoms typically occur in older patients . although the term epicondylitis implied that inflammation is present , it is in fact only present in the very early stages of the disease . this intervention must be compared to the efficacy of a  wait - and - see  policy because the disorder is most often self - limited . reviewed 13 randomized , controlled trials that evaluated the effects of corticosteroid injections compared to placebo injection , injection with local anesthetic and injection with dexamethasone and triamcinolone . although the evaluated evidence showed superior short - term effects of corticosteroid injections for lateral epicondylitis in terms of pain relief and grip strength , no beneficial effects were found for intermediate- or long - term follow - up . among prospective , randomized trials controlled with a placebo injection , altay et al .   compared 60 patients treated with 2  ml lidocaine to 60 patients treated with 1  ml lidocaine combined with 1  ml triamcinolone , with all injections performed with a peppering technique of 4050 injections . another trial compared disabilities of the arm , shoulder , and hand score , grip , and pain in 31 patients injected with lidocaine and dexamethasone and 33 patients injected with lidocaine only . a third trial randomized 19 subjects to receive rehabilitation and a sham injection , and 20 to receive rehabilitation and a corticosteroid injection . there was no significant difference between the two groups on a pain questionnaire , a visual analog pain scale , and a grip measurement at 4 , 8 , and 24  weeks ( p  <  0.05 ) . both groups improved significantly over time , with more than 80% of subjects reporting improvements from baseline to 6  months ( p  <  0.5 ) . bisset et al .   in australia and smidt et al .   in the netherlands randomized patients with tennis elbow to physiotherapy , corticosteroid injection , or a  wait - and - see  approach . in both studies , corticosteroid injection showed significantly better effects at 6  weeks ( p  <  0.01 ) but paradoxically high recurrence rates and significantly poorer outcomes at 1  year ( p  =  0.0001 ) . in a randomized trial comparing steroid injection to naproxen and placebo tablets , injections were better at 4  weeks , but over 80% of patients were better by 52  weeks in all groups with no significant differences ( p  <  0.05 ) . in another double - blinded study comparing different kinds of steroid injections .   found that the early response to steroid preparations was significantly better than for lidocaine ( p  <  0.5 ) , but at 24  weeks , the degrees of improvement were similar . of interest was the discovery that post - injection worsening of pain occurred in approximately half of all steroid - treated patients . the objective of such conservative care is to relieve pain and reduce inflammation , allowing sufficient rehabilitation and return to activities . although this treatment has been described as highly successful , there remains a lack of information concerning the long - term outcome of steroid treatment . in conclusion , i believe that a corticosteroid injection runs the risk of delaying resolution of symptoms in the long run .
lateral epicondylitis or tennis elbow is a painful and functionally limiting entity affecting the upperextremity and is frequently treated by hand surgeons . 
 corticosteroid injection is one of the most common interventions for lateral epicondylitis or tennis elbow . here , a review of the medical literature on this treatment is presented .