Examples
Injections (shots)
|
| dexamethasone | |
| methylprednisolone acetate | Depo-Medrol |
How It Works
Corticosteroids
relieve pain and
inflammation.
A
local anesthetic (lidocaine) may be used first to help
with diagnosis. If this shot improves the pain, then a corticosteroid injection
is given. Lidocaine is sometimes given with a corticosteroid to reduce the pain
of the injection.
Why It Is Used
A corticosteroid injection is
sometimes used to treat
tennis elbow. Corticosteroids are given to relieve the
pain of tennis elbow when other forms of treatment haven't helped.
If you don't find long-term relief after a total of three injections over
the course of a year, more injections aren't likely to help and may cause
harm.
Some doctors believe that corticosteroids should not be
given to children.
Corticosteroid treatment is not used when
infection is suspected.
How Well It Works
Studies suggest that corticosteroid
injections may give short-term relief but don't have long-lasting benefit when
compared to other treatments.1 And a large analysis of many corticosteroid studies suggests that in the long term corticosteroids are worse than other treatments.2 For example, one study found that
although corticosteroid injection produced the most relief after 6 weeks, it
was linked to more relapse and pain after 6 weeks and after 52 weeks than
treatment with watchful waiting or rehabilitation.3
Side Effects
Corticosteroids are used with caution
because of potential side effects. Side effects may include:
- Increased pain the first day or two after a
corticosteroid injection. Apply ice at home for 15 to 20 minutes after the
injection to help reduce pain.
- Tendon weakening and scarring,
causing loss of strength and movement and potential for tendon
rupture.
- Accidental nerve injury during injection.
- Skin
color (pigmentation) changes.
- Dimpling of the skin (subcutaneous
atrophy).
- Infection.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
Try using nonsurgical treatment
(such as rest, rehabilitation exercises, ice, and the use of
nonsteroidal anti-inflammatory drugs) to relieve pain
and inflammation before considering corticosteroids.
There may be
fewer side effects and less pain when corticosteroids are given through
iontophoresis. Iontophoresis is a drug delivery method that uses an electrical
current to move the drug through the skin into the tissue. Because this method
is less painful than hypodermic needle delivery, some people may start
rehabilitation sooner and experience faster pain relief.4
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
References
Citations
- Buchbinder R, et al. (2008). Tennis elbow, search date
August 2006. Online version of BMJ Clinical Evidence:
http://www.clinicalevidence.com.
- Coombes BK, et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. Lancet, 376(9754): 1751–1767.
- Bisset L, et al. (2006). Mobilisation with movement
and exercise, corticosteroid injection, or wait and see for tennis elbow:
Randomised trial. BMJ, 333(7575): 939.
- Nirschl RP, et al. (2003). Iontophoretic
administration of dexamethasone sodium phosphate for acute epicondylitis.
American Journal of Sports Medicine, 31(2):
189–195.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
|---|
| Specialist Medical Reviewer | David Bardana, MD, FRCSC - Orthopedic Surgery, Sports Medicine |
|---|
| Last Revised | January 21, 2011 |
|---|
Last Revised:
January 21, 2011
Buchbinder R, et al. (2008). Tennis elbow, search date
August 2006. Online version of BMJ Clinical Evidence:
http://www.clinicalevidence.com.
Coombes BK, et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. Lancet, 376(9754): 1751–1767.
Bisset L, et al. (2006). Mobilisation with movement
and exercise, corticosteroid injection, or wait and see for tennis elbow:
Randomised trial. BMJ, 333(7575): 939.
Nirschl RP, et al. (2003). Iontophoretic
administration of dexamethasone sodium phosphate for acute epicondylitis.
American Journal of Sports Medicine, 31(2):
189–195.