Why does tennis elbow still hurt after receiving a cortisone injection?

In general, if pain persists after receiving a corticosteroid injection for tennis elbow, it may be due to incomplete healing, incorrect injection placement, insufficient dosage, improper posture, or excessive muscle use. The specific reasons are analyzed as follows:

1. Incomplete Healing

Corticosteroid injections are a common treatment method for tennis elbow, but they may not be effective in all cases. Some patients may require a longer treatment period to achieve full recovery. Persistent pain might occur because the injection failed to resolve the underlying issue.

2. Incorrect Injection Site

Precise placement is crucial when administering a corticosteroid injection. If the injection site is inaccurate or the needle depth is inadequate, the treatment effect may be suboptimal, and the patient may continue to experience pain.

3. Insufficient Injection Dose

If the injected dose is too low, this can also contribute to ongoing symptoms. Most patients experience immediate pain relief after their first corticosteroid injection; however, the medication is eventually metabolized by the body. If the dose is insufficient, pain may return after metabolism, requiring an additional injection for further treatment.

4. Improper Posture

Incorrect posture during certain activities or movements may place excessive stress on the muscles and elbow joint, leading to pain. Adjusting posture appropriately can help alleviate symptoms.

5. Excessive Muscle Use

Tennis elbow is caused by overuse, resulting in degeneration, strain, and aseptic inflammation of the extensor carpi radialis brevis muscle at its attachment point on the lateral epicondyle of the humerus. If the muscles are overused after receiving a corticosteroid injection, pain is likely to recur.

Patients are advised to get adequate rest and avoid strenuous activities. If symptoms persist or fail to improve, timely medical evaluation at a hospital is recommended.