What’s the difference between steroid injections and plasma injections for tennis elbow? I’ve had one steroid injection so far with no results but I don’t want to leap at plasma injections unless they will do some good.

For a long time, steroid injections were the gold standard for lateral epicondylitis (tennis elbow). But studies have shown that this approach may not be as helpful as we once thought.

For one thing, the steroid is always injected in combination with a numbing agent. Patients experience pain relief for the first time and then overuse the arm. The effect of steroids on collagen tissue has also been studied. It looks like steroid injections can actually make permanent changes in the tendon — changes that do not promote healing.

That’s where platelet-rich plasma comes in. Using the patient’s own blood, the plasma with its supply of platelets is injected into the painful tendon. The growth factors in the platelet-rich plasma go right to work creating a healing response within the tendon. The result is a significant relief of pain and improved function.

There is a high rate of recurrence of the painful symptoms associated with tennis elbow after steroid injection. Platelet-rich plasma injection has no similar recurrence rate. Studies from the Netherlands show that the application of platelet-rich plasma is easy, safe, and effective. The only downside is the cost. It is definitely less expensive than surgery but more costly than other conservative approaches.