Double-blind Level 1 RCT comparing a single PRP injection to a single corticosteroid injection in 100 patients with chronic lateral epicondylitis (symptoms >6 months, VAS ≥50). Outcomes were VAS pain and DASH function scores at 4, 8, 12, 26, and 52 weeks. Success was defined as >25% score reduction without reintervention at one year.
Corticosteroid injection was long considered the gold standard for lateral epicondylitis that failed conservative care — this trial is why that view changed. Steroids still win in the first 8 weeks, but their benefit erodes and often reverses by 6 months, while PRP continues to improve.
When a patient with chronic lateral epicondylitis (symptoms >6 months, failed physio and bracing) asks about injection options, PRP offers meaningfully better one-year outcomes. Counsel them that the first month may feel worse with PRP. Local inflammatory pain at 3-4 weeks is expected and does not mean treatment failure.
For the patient who needs to return to work or sport quickly, a corticosteroid injection may still be reasonable first. But if they come back at 3-6 months with recurrent symptoms, PRP is the better next step rather than a repeat steroid injection. The reintervention data make this concrete: 13 patients in the corticosteroid group needed further treatment vs. Only 5 in the PRP group.
Double-blind Level 1 RCT comparing a single PRP injection to a single corticosteroid injection in 100 patients with chronic lateral epicondylitis (symptoms >6 months, VAS ≥50). Outcomes were VAS pain and DASH function scores at 4, 8, 12, 26, and 52 weeks. Success was defined as >25% score reduction without reintervention at one year.
Corticosteroid injection was long considered the gold standard for lateral epicondylitis that failed conservative care — this trial is why that view changed. Steroids still win in the first 8 weeks, but their benefit erodes and often reverses by 6 months, while PRP continues to improve.
When a patient with chronic lateral epicondylitis (symptoms >6 months, failed physio and bracing) asks about injection options, PRP offers meaningfully better one-year outcomes. Counsel them that the first month may feel worse with PRP. Local inflammatory pain at 3-4 weeks is expected and does not mean treatment failure.
For the patient who needs to return to work or sport quickly, a corticosteroid injection may still be reasonable first. But if they come back at 3-6 months with recurrent symptoms, PRP is the better next step rather than a repeat steroid injection. The reintervention data make this concrete: 13 patients in the corticosteroid group needed further treatment vs. Only 5 in the PRP group.