Prospective comparative study of local steroid and autologous blood injection in the treatment of lateral epicondylitis

S Kerakkanavar, V Raghavendra


Background: Tennis elbow (Lateral epicondylitis) frequently encountered myotendinosis affecting around 3 -5 % of population. It’s an ECRB insertion overuse injury at the lateral epicondyle of humerus affecting dominant arm. Non-operative treatment is successful in 80% of patients with tennis elbow. Recent research papers indicate autologous blood injection at the insertion of ECRB proved to be effective in decreasing pain in intermediate and long-term period

Methods: This was a randomized control study done in Rajarajeshwari medical college and hospital, Bengaluru to compare the effectiveness of steroid and autologous blood local injection in terms of controlling pain and disability in short term. Total no. of 40 patients, divided in to 2 groups. One group injected at the site of lateral epicondyle with steroid (methyl prednisolone acetate-40mg) and another group with autologous blood (2ml of venous blood). Patients were followed up at 1st, 4th, and 12th week, pain and disability assessed with visual analogue scale (VAS) and Nirschl staging.

Results: At 1st week corticosteroid injection group (Group I) recorded a statistically significant decrease in pain (VAS Score) compared to autologous blood injection group. At 4th week both group patients had decrease in pain and disability but statistically not significant when compared to each other. At 12th week review, autologous blood injection group (Group II) recorded statistically significant decrease in pain (P-0.0146) and disability (P-0.0001) compared to corticosteroid injection group.

Conclusion: Since autologous blood injection at the lateral epicondyle on OPD basis showed significant improvement in pain and disability, we recommend using same for the treatment of tennis elbow.


tennis elbow, elbow pain, tendinopathy

Full Text:



Coombes BK, Bisset L, Vicenzino B (2010) Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomized controlled trials. Lancet 376:1751-1767.

Chen J, Wang A, Xu J, Zheng M (2010) In chronic lateral epicondylitis, apoptosis and autophagic cell death occur in the extensor carpi radialis brevis tendon. J Shoulder Elbow Surg 19:355-362.

Christian CA, In Campbell's Operative Orthopaedics. S. Terry Canale (Ed). 9th ed. Mosby. St. Louis, Missouri 1998, vol II, p1321-24.

Bisset L, Beller E, Jull G: Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006, 333: 939-944. 10.1136/bmj.38961.584653.AE.

Hakke M Konig IR, Decker T, et al. Extracorporeal shock wave therapy in the treatment of lateral epicondylitis: a randomized multi-center trial. J Bone Joint Surg 2002; 84A; 1982-1991.

Grifka J, Boenke S, Kramer J. Endoscopic therapy in epicondylitis radialis humeri. Arthroscopy 1995; 11:743-748.

Placzek R, Drescher W, Deuretzbacher G: Treatment of chronic radial epicondylitis with botulinum toxin a: a doubleblind, placebo-controlled, randomized multicenter study. J Bone Joint Surg Am. 2007, 89: 255-260. 10.2106/JBJS.F.00401.

Owens BD, Murphy KP, Kuklo TR. Arthroscopic release for lateral epicondylitis. Arthroscopy 2001; 17:582-587.

Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Bone Joint Surg. 2003; 28(A):272-278.

Nirschl RP: Elbow tendinosis/tennis elbow. Clin Sports Med. 1992, 11: 851-870.

Runge F: Zur genese und behandlung des schreibekrampfes. Berl. Klin. Wochenschr. 1873, 10: 245-248.

Bishai SK, Plancher KD: The basic science of lateral epicondylosis: update for the future. Tech Orthop. 2006, 21: 250-255. 10.1097/01.bto.0000252115.76643.78.

Bisset L, Beller E, Jull G: Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006, 333: 939-944. 10.1136/bmj.38961.584653.AE.

D’Vaz AP, Ostor AJ, Speed CA: Pulsed low-intensity ultrasound therapy for chronic lateral epicondylitis: a randomized controlled trial. Rheumatology (Oxford). 2006, 45: 566-570. 10.1093/rheumatology/kei210.

Mishra A, Pavelko T: Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. 2006, 34: 1774-1778. 10.1177/0363546506288850.

Vos RJ, Veldhoven PLJ, Moen MH, Weir A, Tol JL, Maffulli N: Autologous growth factor injections in chronic tendinopathy: a systematic review. Br Med Bull. 2010, 95: 63-77. 10.1093/bmb/ldq006.

Kalaci A, Cakici H, Hapa O: Treatment of plantar fasciitis using four different local injection modalities: a randomized prospective clinical trial. J Am Podiatr Med Assoc. 2009, 99: 108-113.

Kazemi M, Azma K, Tavana B, Rezaiee Moghaddam F, Panahi A: Autologous blood versus corticosteroid local injection in the short-term treatment of lateral elbow tendinopathy: a randomized clinical trial of efficacy. Am J Phys Med Rehabil. 2010, 89: 660-667. 10.1097/PHM.0b013e3181ddcb31.

Andia I, Sanchez M, Maffulli N: Tendon healing and platelet-rich plasma therapies. Expert Opin Biol Ther. 2010, 10 (10): 1415-1426. 10.1517/14712598.2010.514603.

Balasubramaniam P, Prathap K: The effect of injection of hydrocortisone into rabbit calcaneal tendons. J Bone Joint Surg. 1972, 54B: 729-734.


  • There are currently no refbacks.

Copyright (c) 2018 S Kerakkanavar, V Raghavendra

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.