Tennis elbow and Golfer’s elbow
Referrals for USS guided steroid injections to RCHT Clinical Imaging have restarted. Please note there is limited capacity so referrals should be reserved for patients with significant disabling and persistent symptoms. Please click here for full details
Covid-19 Update: Corticosteroid Injections During The Coronavirus Pandemic
Please note that any patients considering steroid injections during the Coronavirus pandemic require a risk assessment and counselling on increased risks with Covid prior to performing. Secondary care referrals for steroid injection, including image guided injections, require the patient to be counselled and risk assessed prior to referral and this documented in the referral. Please see guidance available here for detailed information.
Both conditions are self-limiting with an average duration of between 6 months to two years
For more than 90% of patients, non-surgical measures are successful
Differential Diagnoses
- Referred pain from the cervical spine
- Referred pain from shoulder or wrist injuries
- Osteoarthritis
- Radial tunnel syndrome (compression of the posterior interosseous nerve).
Primary care management:
- Rest the arm and reduce aggravating activities(whilst maintaining normal activity where possible) for 6 weeks
- Physiotherapy
- Appropriate tailored analgesia
- Steroid injection May be helpful for short term relief of severe pain, however unlikely to affect long term outcome and relapses are common, not routinely recommended
- Orthoses such as forearm bands can be helpful especially with functional impairment
Acupuncture is not recommended
Referral Criteria
- The diagnosis is uncertain.
- Pain or functional limitation is severe.
- Functional disability and pain persist after 6–12 months of non-surgical management.
References
National Institute Of Clinical Excellence. Tennis Elbow. Clinical Knowledge Summaries, April 2015
Bisset, L., Coombes, B and Vicenzino, B. Tennis elbow.Clinical Evidence BMJ Publishing; 2011
Bisset, L., Beller, E., Jull, G. et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. British Medical Journal; 2006 333(7575), 939
Date reviewed 11/03/2022
Next review due 11/03/2023
Sifter name Dr Rebecca Hopkins
Version No. 1.2