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Systematic review
Corticosteroid injection for lateral epicondylalgia is helpful in the short term, but harmful in the longer term; data for non-corticosteroid injections and other tendinopathies are limited
  1. John Orchard
  1. School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to John Orchard
    Sports Medicine at Sydney University, University of Sydney, Cnr Western Avenue and Physics Road, Sydney, NSW 2006, Australia; john.orchard{at}

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Cortisone injections have been an accepted and recommended treatment for chronic tendinopathies for many years, including tennis elbow (lateral epicondylitis), Achilles tendinopathy and rotator cuff tendinopathy. Most of the recommendations to use cortisone injections are based on case series or controlled studies with short-term follow-up. However, theoretical objections have been raised against the use of cortisone, particularly that tendinopathy is not generally an inflammatory disorder. There have been reported associations of tendon weakening and rupture after cortisone injections. Tendinopathy experts have argued for years that, since inflammation is not a major part of the pathology, anti-inflammatory treatment such as cortisone injections may not be ideal management.1,,4


Coombes and colleagues used a systematic review with meta-analysis approach to compile the results of randomised controlled trials (RCTs) of injection for tendinopathies and effects in the short term (4 …

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