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Platelet-rich plasma provides better long-term pain management and functional improvement than corticosteroid injections in lateral epicondylitis/tennis elbow.
Lateral epicondylitis, widely known as tennis elbow, is one of the key causes of elbow pain and upper-limb disability, influencing predominantly middle-aged adults. Often triggered by repetitive arm movements, the condition is now recognized as a degenerative rather than inflammatory ailment. While its prognosis is generally favorable, the associated healthcare costs and impact on daily activities continue to drive the search for effective non-operative therapies.
A comprehensive new meta-analysis has provided fresh insight into the comparative potency of platelet-rich plasma (PRP) and corticosteroid injections for lateral epicondylitis management. The study analyzed evidence from 26 randomized controlled trials involving 1,877 subjects, making it one of the largest evaluations of these commonly used injectable treatments. Researchers systematically explored PubMed, Cochrane, and Google Scholar and incorporated only randomized controlled trials. Treatment efficacy was assessed via two widely accepted outcome measures: the visual analog scale (VAS) for pain and the disabilities of the arm, shoulder, and hand (DASH) score for functional status.
The analysis revealed distinct differences in treatment performance over time. For pain relief measured by VAS, corticosteroid injections illustrated a significant short-term advantage within the first two months after treatment (P=0.03; mean difference [MD], 0.67). However, between two and six months, no prominent differences were observed between the two interventions. The trend reversed during long-term follow-up.
Beyond six months, PRP injections were linked with significantly greater pain reduction than corticosteroids (P<0.001; MD, −1.60), indicating more sustained symptom control. Functional outcomes followed a similar pattern. DASH scores showed no vital differences between PRP and corticosteroids during short-term and intermediate-term follow-up. Nevertheless, PRP demonstrated a clear long-term functional advantage, with significantly better DASH scores after six months (P<0.001; MD, −4.87).
Overall, the findings suggest that corticosteroid injections may be most beneficial for those seeking rapid symptom relief, whereas PRP yields superior durability, delivering both long-term pain reduction and improved upper-extremity function. The authors concluded that corticosteroids provide significantly better short-term pain control, while PRP yields better long-term clinical and functional outcomes. Given these findings, future research should investigate optimized injection protocols and assess whether combining injectable therapies with other non-invasive treatment modalities can further improve outcomes for lateral epicondylitis sufferers.
Clinics in Shoulder and Elbow
Platelet rich plasma versus corticosteroids for lateral epicondylitis: a meta-analysis of randomized clinical trials
Ralph Maroun et al.
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