In the late 1940s, the steroid cortisone, an anti-inflammatory drug, was first synthesized and hailed as a landmark. Cortisone shots became one of the preferred treatments for overuse injuries of tendons, like tennis elbow or an aching Achilles, which had been notoriously resistant to treatment. The shots were quite effective, providing rapid relief of pain.
Even though an article in the ’50s pointed out some negative aspects of cortisone, today cortisone shots remain a standard, much-requested treatment for tennis elbow and other tendon problems.
A recent review article in The Lancet raises questions on cortisone safety and efficacy. The review looked at the results of 48 randomized trials, covering thousands of people with tendon injuries including tennis elbow and Achilles-tendon pain. Over all, people who received cortisone shots had short term pain relief but a much lower rate of full recovery than those who did nothing or who underwent physical therapy. They also had a 63 percent higher risk of relapse. Those people receiving multiple injections may be at particularly high risk for continuing damage.