Injections for Treating Tennis Elbow

There are many options for the treatment of tennis elbow. Different healthcare providers may recommend different treatments. The reason you may hear these differing recommendations is that there are a lot of options for treatment, and the scientific research is conflicting regarding which is best. What we do know is that most people will get better with time, regardless of what treatment is used to control symptoms.

There are several types of injections that have been used for the treatment of tennis elbow, but there is little to suggest that one type of injection is better than any other. In fact, there is probably more data to suggest that, in the long term, no injection may be the best treatment. However, many patients are looking for immediate relief of pain and therefore turn to injections to provide pain reduction and allow them to resume their activities.

Illustration showing tennis elbow
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Tennis elbow is a condition that causes chronic tendon damage to the tendon on the outside of the elbow joint.The tendon is usually damaged as a result of an overuse condition, such as sports or work activities. The type of tendon damage, called tendinosis, causes chronic tendon irritation and microscopic tears. When the damaged tendon is inspected under a microscope, the tendon is seen to have scar tissue and blood vessel formation—evidence of a chronic healing process. What is not seen under the microscope is evidence of inflammation, as is the case with tendonitis.

Cortisone Injections

Cortisone injections are used for a variety of orthopedic conditions, including tennis elbow. Cortisone is a powerful anti-inflammatory medication, meaning it helps to control inflammation. The use of cortisone in the treatment of tennis elbow has been questioned by some because tennis elbow does not cause inflammation of the tendon. Therefore, treatment of tennis elbow with a medication that reduces inflammation is debated.

PRP Injections

Platelet-rich plasma (PRP) injections have recently become popular. PRP is created by separating your blood into different components. PRP contains a high concentration of platelets, a part of blood that naturally contains growth factors. These growth factors are thought to naturally stimulate a healing process. However, there is currently no data to fully support the use of PRP injections. Furthermore, they can be costly.

Autologous Blood Injections

Autologous blood injections are simply injections of your own blood. Similar to PRP, the theory behind the use of autologous blood is that injections of your own blood will stimulate a healing response in the affected tendon. The only difference between autologous blood and PRP is that the autologous injections are not a concentrated component of the blood.

Which Injection?

There has been no good evidence that any one of these injections is better than another. In fact, in a study in the Journal of Hand Surgery, different injections were compared to injections of saline (placebo injections). The different injections were wrapped so patients wouldn't know which solution they were receiving, and all patients had blood drawn so that they wouldn't know if they were getting a blood injection. In the end, all of the patient groups showed improvement (including the placebo group), and none did significantly better than any other group.

A placebo-controlled study demonstrates that one of the most important requirements for the healing of tennis elbow is time.

A Word From Verywell

Allowing the body time to heal can be one of the most effective treatments for many medical conditions. If an injection can help control the symptoms of tennis elbow pain while your body is healing, it may be reasonable to try it. The only treatment that may be worth avoiding is PRP. These injections are very expensive and have yet to show any benefit over injections that cost a small fraction of the cost. That said, PRP, and all of the other injections discussed above, are generally safe and reasonable to discuss with your healthcare provider.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sanders TL, Maradit kremers H, Bryan AJ, Ransom JE, Smith J, Morrey BF. The epidemiology and health care burden of tennis elbow: a population-based study. Am J Sports Med. 2015;43(5):1066-71. doi:10.1177/0363546514568087

  2. Kwapisz A, Prabhakar S, Compagnoni R, Sibilska A, Randelli P. Platelet-Rich Plasma for Elbow Pathologies: a Descriptive Review of Current Literature. Curr Rev Musculoskelet Med. 2018;11(4):598-606. doi: 10.1007/s12178-018-9520-1

  3. Gani NU, Khan HA, Kamal Y, Farooq M, Jeelani H, Shah AB. Long term results in refractory tennis elbow using autologous blood. Orthop Rev (Pavia). 2014;6(4):5473. doi:10.4081/or.2014.5473

  4. Wolf JM, Ozer K, Scott F, Gordon MJ, Williams AE. Comparison of autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: a prospective, randomized, controlled multicenter study. J Hand Surg Am. 2011;36(8):1269-72. doi:10.1016/j.jhsa.2011.05.014

Additional Reading

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.