Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials

@article{Coombes2010EfficacyAS,
  title={Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials},
  author={Brooke K. Coombes and Leanne M Bisset and Bill T Vicenzino},
  journal={The Lancet},
  year={2010},
  volume={376},
  pages={1751-1767}
}
Pharmacological interventions for the treatment of Achilles tendinopathy: a systematic review of randomized controlled trials.
TLDR
There is not univocal evidence to advise any particular pharmacological treatment as the best advisable non-operative option for Achilles tendinopathy as equivalent alternative to the most commonly used eccentric loading rehabilitation program, but potential was shown by the combination of different substances administered with physical therapy.
The efficacy of low-level laser therapy for shoulder tendinopathy: a systematic review and meta-analysis of randomized controlled trials.
TLDR
It is shown that optimal LLLT can offer clinically relevant pain relief and initiate a more rapid course of improvement, both alone and in combination with physiotherapy interventions.
Comparative Effectiveness of Injection Therapies in Lateral Epicondylitis
TLDR
A systematic review and network meta-analysis of randomized controlled trials found a paucity of evidence from unbiased trials on which to base treatment recommendations regarding injection therapies for lateral epicondylitis.
Clinical management of tendinopathy: A systematic review of systematic reviews evaluating the effectiveness of tendinopathy treatments
TLDR
Eccentric exercises were the most common and consistently effective treatment for tendinopathy across systematic reviews, and minimally invasive procedures were more effective compared to open surgical interventions.
Treating lateral epicondylitis with corticosteroid injections or non-electrotherapeutical physiotherapy: a systematic review
TLDR
Corticosteroid injections have a short-term beneficial effect on lateral epicondylitis, but a negative effect in the intermediate term, and evidence on the long-term effect is conflicting.
Are corticosteroid injections more beneficial than anaesthetic injections alone in the management of rotator cuff-related shoulder pain? A systematic review
TLDR
Corticosteroid injections may have a short-term benefit (up to 8 weeks) over local anaesthetic injections alone in the management of RCRSP, but beyond 8 weeks, there was no evidence to suggest a benefit of corticosteroids over local Anaesthetic injections.
Sclerotherapy and prolotherapy for chronic patellar tendinopathies - a promising therapy with limited available evidence, a systematic review
TLDR
There seems to be some evidence that ST and PT may be effective treatment options to treat pain and to improve function in patients with CPT, but more research is needed with larger volume studies and randomized controlled studies with long term follow up.
The effects of regenerative injection therapy compared to corticosteroids for the treatment of lateral Epicondylitis: a systematic review and meta-analysis
TLDR
Regenerative injections provision results in greater long-term pain relief and improved function for people with lateral epicondylitis, compared with corticosteroid injections provision.
Efficacy of high-volume injections with and without corticosteroid compared with sham for Achilles tendinopathy: a protocol for a randomised controlled trial
TLDR
The primary outcome measure will be the Victorian Institute of Sport Assessment – Achilles at 12 months post-randomisation, a validated, reliable and disease-specific measure of pain and function, which was informed by core outcome domains for tendinopathy.
...
...

References

SHOWING 1-10 OF 67 REFERENCES
Efficacy and safety of steroid injections for shoulder and elbow tendonitis: a meta-analysis of randomised controlled trials
TLDR
Steroid injections are well tolerated and more effective for tendonitis in the short-term than pooled other treatments, though similar to NSAIDs.
Pragmatic randomised controlled trial of local corticosteroid injection and naproxen for treatment of lateral epicondylitis of elbow in primary care
TLDR
This large pragmatic randomised trial showed that corticosteroid injection was significantly better than non-steroidal anti-inflammatories or placebo tablets at four weeks.
Optimising corticosteroid injection for lateral epicondylalgia with the addition of physiotherapy: A protocol for a randomised control trial with placebo comparison
TLDR
Evaluated clinical efficacy, cost-effectiveness and recurrence rates of adding physiotherapy to an injection and the clinical efficacy and adverse effects of corticosteroid injection beyond that of a placebo saline injection are studied.
Systematic review of randomised controlled trials of interventions for painful shoulder: selection criteria, outcome assessment, and efficacy
TLDR
Little evidence to support the use of any of the common interventions in managing shoulder pain is found and more research is needed to establish a uniform method of defining shoulder disorders and developing outcome measures which are valid, reliable, and responsive in affected people.
Achilles Tendonitis: Are Corticosteroid Injections Useful or Harmful?
  • I. Shrier, G. Matheson, H. Kohl
  • Medicine
    Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
  • 1996
TLDR
There are insufficient published data to determine the comparative risks and benefits of corticosteroid injections in Achilles tendonitis and the decreased tendon strength with intratendinous injections in animal studies suggests that rupture may be a potential complication for several weeks following injection.
Corticosteroid injections for shoulder pain
TLDR
Subacromial corticosteroid injection for rotator cuff disease and intra-articular injection for adhesive capsulitis may be beneficial although their effect may be small and not well-maintained.
Steroid injection therapy is the best conservative treatment for lateral epicondylitis: a prospective randomised controlled trial
TLDR
On the basis of the results of this study, the authors advocate steroid injection alone as the first line of treatment for patients presenting with tennis elbow demanding a quick return to daily activities.
Efficacy of Injections of Corticosteroids for Subacromial Impingement Syndrome*
TLDR
It is concluded that subacromial injection of corticosteroids is an effective short-term therapy for the treatment of symptomatic subacROMial impingement syndrome and the use of such injections can substantially decrease pain and increase the range of motion of the shoulder.
...
...