A Review of Lateral Epicondylitis Injection: Drugs Used, Injection Techniques and Guidance Method

Abstract

Abstract This article aimed to study the most suitable drug for injection, injection techniques and guidance method for treating tennis elbow. The words ‘injection technique’, ‘lateral epicondylitis’ and ‘tennis elbow’ were keyed into PubMed search base, and 145 full-text English language articles were obtained, from which 22 articles were deemed suitable for review based on content and relevance. One article was added from the author’s collection. The eligibility was (a) patients with tennis elbow or lateral epicondylitis, (b) patients who had undergone injection therapy and (c) studies that had done a comparison between two or more agents or two techniques or used comparison between using or not using imaging guidance for injection. It was found that corticosteroid injections in tennis elbow produce a short-term improvement in symptoms, while prolotherapy, autologous blood and platelet-rich plasma (PRP) injections may show more efficacy in the long term. In terms of technique, peppering seems to be a better alternative to tender point injections. The use of ultrasound guidance does not seem to have any effect on the overall efficacy of the injection treatment. The evidence in this study shows that it is better to use corticosteroids for short-term improvement, whereas bioactive agents like PRP injections may work better in the long term.