Corticosteroid versus platelet-rich plasma injection in epicondylitis

Lateral epicondylitis (LE) is often considered an inflammatory disease characterized by tendon microtears that are followed by an incomplete reparative response that leads to chronic pain and decreased function on the upper extremity. A modality that is commonly used for the treatment of LE is the injection of corticosteroids. Evidence supports corticosteroid injections to be an effective short-term intervention that lacks intermediate and long-term relief as well as having negative effects on tenocyte proliferation, which is essential in the tissue healing process. Platelet-rich plasma (PRP) has been shown to be more effective, providing longer positive results with a lower recurrence rate. PRP's powerful growth factor stimulates tissue repair and protects tenocytes from the cytotoxic effects caused by corticosteroids. Unfortunately, the efficacy of PRP has been questioned because of past study designs. Nevertheless, recent studies provide practice-changing evidence that supports the use of PRP for the treatment of LE.