I regularly review newly published, high-quality medical research and share patient-focused summaries explaining what the evidence means in everyday practice. These updates are intended to support informed discussions and shared decision-making, while recognising that treatment should always be tailored to the individual.
At the heart of my practice is Shared Decision-Making. Whether we pursue conservative management (Plan A) or surgical intervention (Plan B), the goal is to create a tailored treatment plan that aligns with your lifestyle, values, and functional goals.
Prepared by:
Prof. Bijay Singh
Consultant Orthopaedic Surgeon – Upper Limb, Trauma & Sports Injury
Shoulder | Elbow | Wrist | Hand
Visiting Professor Canterbury Christchurch University & AIIMS Raipur
NHS Appointments:
Spire Alexandra Hospital: 01634 – 687166
Medway NHS Trust: 01634 – 976749
Spire Alexandra Hospital
Medway NHS Trust
Tennis elbow, or lateral epicondylitis, is a common cause of pain on the outside of the elbow. Despite its name, it does not only affect tennis players. It is frequently seen in manual workers, office staff, and anyone who performs repetitive gripping or lifting activities.
If you’ve been diagnosed with tennis elbow (lateral epicondylitis), you’re likely facing a choice: a corticosteroid injection (the “quick fix”) or Regenerative Injection Therapy (PRP) (the “slow builder”).
What is tennis elbow?
Tennis elbow is usually caused by degeneration of the tendon on the outside of the elbow due to repeated strain. It is not purely an inflammatory condition, especially in long-standing cases.
Common symptoms include:
- Pain on the outside of the elbow
- Weak grip strength
- Difficulty lifting or twisting objects
Recent medical breakthroughs have finally given us a clear timeline of how these treatments actually perform. Spoiler: It’s a classic case of the Tortoise and the Hare.
1. The Sprint: Corticosteroids (The First 30 Days)
If you have a wedding this weekend or a major presentation and can’t even hold a pen, steroids might look like a hero.
The 2023 Hohmann study confirmed that at the 1-month mark, corticosteroids are statistically superior for both pain relief and hand function. However, the researchers noted a catch: the evidence for this early “win” isn’t as robust as we once thought. It’s essentially a temporary “mask” for the pain.
2. The Cross-Over: The 3-Month Shift
This is where the tide turns. By the 3-month mark, the effects of the steroid shot begin to fade, while the regenerative therapy (PRP) is just getting started.
- Pain:At 3 and 6 months, patients who received PRP reported significantly lower pain levels (at 3 months; at 6 months).
Function: Your ability to use your arm for daily tasks (the DASH score) also shifts in favour of PRP at the 3-month mark.
3. The Marathon: Regenerative Therapy (2 Years and Beyond)
The 2019 Barnett study looked even further down the road. They found that while there’s no difference in the first two months, the “long-haul” benefits of regenerative injections are undeniable.
The Result: Participants receiving regenerative injections demonstrated greater improvements that lasted for over 2 years.
While a steroid shot often results in the pain coming back (and potentially weakening the tendon), regenerative therapy actually works to repair the tissue using your own blood’s healing factors.
At-a-Glance Comparison Table
| Milestone | Corticosteroid (The “Hare”) | Regenerative/PRP (The “Tortoise”) | Winner |
| 1 Month | High pain relief & function | Slower initial response | Steroids |
| 3 Months | Relief begins to “wear off” | Healing response kicks in | Regenerative |
| 6 Months | Pain often returns to baseline | Superior pain & function scores | Regenerative |
| 2+ Years | High recurrence/Retreatment | Durable, lasting recovery | Regenerative |
