Tennis elbow, or lateral epicondylitis, is a painful condition that affects the outer part of the elbow. Despite the name, it doesn’t just affect athletes. Anyone who performs repetitive motions involving the forearm, like typing, painting, or using tools, can develop it.

When rest, physical therapy, and medications fail to bring relief, injections can be an effective next step in managing symptoms.

But what exactly are tennis elbow injections? How do they work, and are they safe? This guide explores the types of injections used for tennis elbow, how the procedure is performed, the benefits you might expect, and the potential risks.

What Is Tennis Elbow?

Tennis elbow injections are caused by overuse of the tendons that attach to the lateral epicondyle of the humerus—the bony bump on the outside of the elbow. This leads to tiny tears in the tendon, causing pain, tenderness, and difficulty with grip strength.

Common symptoms include:

·       Pain or burning on the outer part of the elbow

·       Weakened grip strength

·       Discomfort when lifting, gripping, or twisting motions

Conservative treatments like rest, ice, NSAIDs (non-steroidal anti-inflammatory drugs), and physical therapy are often first-line strategies. However, persistent or severe symptoms may require more targeted intervention, such as an injection.

Types of Injections for Tennis Elbow

Several types of injections are used to treat tennis elbow, depending on the cause, severity, and patient preferences.

1. Corticosteroid Injections

Corticosteroids are powerful anti-inflammatory medications. They are often used to provide short-term pain relief and reduce inflammation around the damaged tendon.

Benefits: Fast pain relief, usually within a few days

Duration: Relief may last weeks to months

Limitation: Repeated injections may weaken tendons over time and are not recommended as a long-term solution

2. Platelet-Rich Plasma (PRP) Injections

PRP therapy uses a concentration of the patient’s platelets—rich in healing factors—to promote tendon repair and reduce pain.

Benefits: May promote actual tissue healing rather than just masking symptoms

Duration: Effects are gradual and can take several weeks to months to manifest

Limitation: May be expensive and not always covered by insurance

3. Hyaluronic Acid Injections

More commonly used for joint lubrication in conditions like knee arthritis, hyaluronic acid has also been explored as a treatment for tennis elbow. However, evidence is limited, and it’s not a first-line option.

4. Botulinum Toxin (Botox) Injections

Botox can paralyze specific muscles to reduce strain on the tendons. It’s rarely used for tennis elbow but may be considered in select cases.

How the Procedure Is Done

Most elbow injections are performed in a doctor’s office and take only a few minutes. Here’s what typically happens:

Step-by-Step:

Preparation: The skin over the elbow is cleaned and sterilized.

Anesthesia (Optional): A local anesthetic may be applied to minimize discomfort.

Injection: Using a fine needle, the medication is injected into the area near the tendon.

Ultrasound guidance may be used for precise placement.

Post-Procedure: A bandage is applied, and patients are monitored briefly before going home.

Recovery Tips:

Rest the arm for 24–48 hours

Avoid strenuous activity for a few days

Ice the area if soreness occurs

Monitor for signs of infection, like redness, warmth, or increased pain

Benefits of Tennis Elbow Injections

Injections can be particularly beneficial for individuals who:

Have persistent elbow pain despite conservative treatments

Need short-term relief to engage in physical therapy

Want to avoid or delay surgery

Have functional limitations impacting daily life or work

Expected Outcomes:

Corticosteroids: Quick symptom relief, particularly useful for acute flare-ups

PRP: Slower, more sustainable improvement, especially in chronic cases

Overall: Improved pain, increased grip strength, and better range of motion

Risks and Side Effects

Although generally safe, elbow injections do carry potential risks:

Common (Usually Minor):

Pain or swelling at the injection site

Temporary increase in symptoms (especially with PRP)

Bruising

Less Common but Serious:

Infection: A rare but serious complication

Allergic reactions: To medication or anesthetic

Tendon weakening or rupture: Particularly with repeated corticosteroid use

Skin discoloration or fat atrophy: Cosmetic side effects near the injection site

Because of these risks, most physicians limit corticosteroid injections to 2-3 per year in the same area.

Who Should Avoid Injections?

Tennis elbow injections may not be suitable for everyone. Contraindications include:

Active infections (systemic or localized)

Bleeding disorders or patients on anticoagulants (unless managed)

Allergy to any injection components

Severe tendon degeneration or partial tear (may require surgical evaluation)

Consult your physician to determine if you're a good candidate based on your health status and treatment history.

Comparing Injections to Other Treatments

Treatment	Invasiveness	Speed of Relief	Long-Term Benefit	Cost
Corticosteroid Injection	Low	Fast	Short to moderate	Low
PRP Injection	Low	Slow	Moderate to long	High
Physical Therapy	None	Gradual	Long-term if consistent	Moderate
Surgery	High	Delayed	Long-term	High

Injections can serve as a bridge treatment, reducing pain enough for patients to resume therapy or avoid surgery.

Final Thoughts

Tennis elbow injections can be a powerful tool in managing lateral epicondylitis, especially when other treatments haven’t worked. They offer an effective, minimally invasive option to reduce pain and improve function. Whether you opt for corticosteroids, PRP, or another method, understanding the risks and benefits is essential to making an informed choice.

Work closely with your healthcare provider to determine which injection—if any—is appropriate for your condition. With the right approach, you can get back to the activities you enjoy without chronic elbow pain holding you back.