Tennis Elbow: Steroid Injection Side Effects Explained

Tennis elbow may experience discomfort after receiving corticosteroid injections in orthopedics?

After being diagnosed with tennis elbow at a rehabilitation clinic, I underwent therapy for about three months.
I then switched to an orthopedic specialist, who also diagnosed me with tennis elbow and administered a corticosteroid injection at the pain site.
Initially, there was no pain after the injection, but when I returned home, my arm became nearly stiff and I had difficulty moving and exerting force.
After a day or two, there was some improvement.
Three days after the injection, my arm started to feel very weak; it would tremble slightly when not holding anything, and there was still some tenderness at the injection site.
My arm lacked strength when trying to make a fist, and it felt weak and fatigued overall, with occasional pain.

Yande, 20~29 year old female. Ask Date: 2020/12/01

Dr. Wang Zhaomin reply Rehabilitation

Corticosteroid injections are one of the treatment options for tennis elbow.
A small number of individuals may experience discomfort after the injection, which can be alleviated with ice or heat therapy to reduce post-injection pain.
If there is no improvement after one week, it is recommended to return for a follow-up appointment to assess the condition.

Reply Date: 2020/12/01

More Info

Tennis elbow, or lateral epicondylitis, is a common condition that arises from overuse of the forearm muscles and tendons, leading to pain and tenderness on the outer part of the elbow. When conservative treatments such as physical therapy and rest fail to alleviate the symptoms, corticosteroid injections may be considered as a treatment option. While these injections can provide significant relief, they are not without potential side effects.

In your case, after receiving a corticosteroid injection for tennis elbow, you experienced a range of symptoms including stiffness, weakness, and pain at the injection site. These reactions can be attributed to several factors related to the injection and the underlying condition.

1. Immediate Effects of Corticosteroid Injection: Corticosteroids are anti-inflammatory medications that can provide rapid relief from pain and inflammation. However, the immediate aftermath of the injection can sometimes lead to temporary discomfort or stiffness in the area. This is often due to the injection itself, which can cause localized irritation or inflammation.

2. Weakness and Fatigue: It is not uncommon to experience weakness in the arm following a corticosteroid injection. This can be due to a combination of factors, including the body's response to the medication and the temporary immobilization of the arm to allow for healing. The sensation of your arm feeling "soft" or "weak" may also be a psychological response to the pain and discomfort you were experiencing prior to the injection.

3. Delayed Onset of Symptoms: The symptoms you described, such as weakness and tremors, may also be related to the underlying condition of tennis elbow rather than the injection itself. Tennis elbow can lead to muscle imbalances and weakness in the forearm, which may become more pronounced after the inflammation is reduced. As the pain subsides, you may become more aware of these weaknesses.

4. Potential Side Effects of Corticosteroids: While corticosteroids are effective in reducing inflammation, they can also have side effects. Common side effects include temporary pain at the injection site, skin thinning, and changes in skin pigmentation. In some cases, patients may experience a "steroid flare," where the pain temporarily worsens before improving. This is usually self-limiting and resolves within a few days.

5. Follow-Up Care: It is essential to maintain communication with your healthcare provider following a corticosteroid injection. If your symptoms persist or worsen, it may indicate that further evaluation is necessary. Your doctor may recommend additional physical therapy, modifications to your activity level, or alternative treatments to address your ongoing symptoms.

6. Rehabilitation: After receiving a corticosteroid injection, it is crucial to engage in a structured rehabilitation program. This may include stretching and strengthening exercises tailored to your specific needs. Gradually increasing the load on the forearm muscles can help restore strength and function while minimizing the risk of re-injury.

In summary, while corticosteroid injections can provide significant relief for tennis elbow, they can also lead to temporary side effects such as stiffness, weakness, and localized pain. It is essential to monitor your symptoms and maintain an open line of communication with your healthcare provider to ensure appropriate management of your condition. Engaging in a comprehensive rehabilitation program can further enhance recovery and prevent future episodes of tennis elbow.

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