Being a tennis player myself, I have suffered from this condition. The outside elbow, where the lower arm tendon inserts on the epicondyle bone gets inflamed and swinging a racket or even lifting a carton of milk out of the refrigerator can cause excruciating pain. This is a very common condition and can be caused by any repetitive motion of that muscle. One of my patients got it from clipping roses. Traditionally the treatment is anti-inflammatory medication (ibuprofen, aleeve), ice and rest. For serious cases, physiotherapy and injection with a corticosteroid has always proved effective in my practice.
The researchers found, however, that patients treated with a single corticosteroid injection had a 14% greater chance of poor outcome and a 77% increased risk for re-injury at 1 year relative to placebo. Eight weeks of physical therapy appeared to have no long-term benefit with the exception of decreased analgesic use.
The researchers compared corticosteroid injection with placebo injection and found no difference at one year. The corticosteroid injection did reduce pain at four weeks compared to placebo injection. At 26 weeks that corticosteroid injected patients did worse than the placebo injection. Physiotherapy patients had better pain relief at 4 weeks but no difference at one year.
How can we explain these results? The decreased pain relief at 4 weeks may have allowed the patient to resume activity or engage in excessive activity before the healing was complete. Pain is the body's way of telling us to do something different.