Corticosteroid Injection Side Effects for Golfers Elbow

Corticosteroid Injection Side Effects for Golfers Elbow post image

I do try to keep up with what’s going on in the medical profession when it comes to golfer’s elbow treatment and recently came across this interesting article regarding a particular case of steroid injection for golfer’s elbow. If you don’t like all the technical speak, skip straight to the last sentence which is the most important one:

Examination revealed atrophy of the skin and subcutaneous fat over the medial epicondyle causing the epicondyle to become prominent like an osseous mass (). Marked tenderness was observed over the prominent medial epicondyle by palpation.

Intraoperatively, the atrophied skin and subcutaneous fat tissue were excised from an ellipsoid incision. Two chalky, whitish deposits of corticosteroid were observed over the flexor aponeurosis. The deposits were excised. The common flexorpronator origin was partially detached by sharp dissection and reflected without disturbing the medial collateral ligament. The underlying fibrous tissue was debrided. The medial epicondyle was drilled, creating multiple bleeding small holes, and then the flexorpronator origin was reattached. The adjacent subcutaneous tissue and skin were released and brought over the epicondyle, forming good soft tissue coverage. Three years postoperatively, the patient had unlimited range of elbow motion with no epicondylar pain, and no pathologic bony prominence of the epicondyle was observed.

Although steroid injection for the conservative treatment of medial epicondylitis is an alternative method, previously reported complications of periarticular injections and the case presented here demonstrate related adverse effects or complications. Injection into the medial site of the elbow may not be as innocent as expected if appropriate injection technique is disregarded.

Now I don’t want to be a doom munger here and if you read the 150+ comments on my golfer’s elbow cure page, you’ll notice that a few people have experienced good success with steroid injections, and I realise that this article is referring to poor injection technique. However my personal view is that injections of corticosteroid for medial epicondylitis is generally a bad idea. Not just because it can go wrong, in the case of the lady above, but also because it’s just masking the pain rather than treating the cause. If you like weightlifting like I do, I think there’s a real risk of making the injury worse. After all, the pain is there to make you aware that something is wrong and needs your attention. Pain is your friend!

As if getting over golfer’s or tennis elbow wasn’t wasn’t bad enough, you have to watch out for scammers too. Take a look at this blatant scammer on Amazon selling a single elbow pain product called TenDLite LED. Why do I say this is a scam? Here’s why (figures correct at the time of writing):

  • There are 7 reviews for the product, all suspiciously 5 star with 5 of them very suspiciously submitted on the same day (20th April) with a 6th the day after (21st April).
  • Between the 7 reviewers, they have only done 12 reviews in total, an amazing 10 of them are for the TenDLite LED (3 have reviewed it twice, including a previously withdrawn TenDLite LED listing).
  • Despite the 10 impressive 5 star reviews, TenDLite as a seller has only had 4 life time purchase ratings!
  • Checking the TenDLite website “FDA Approved” is all over it, except where, in their haste to shout this from the rafters, it was misspelled as “FAD Aprooved“, along with “Strenght and flexibility“. It may be being picky, but basic spelling mistakes are fairly dodgy.

Maybe I’m being harsh, but I don’t think I’m wrong. Watch out guys and gals, not all is as it seems out there, and at the end of the day, it’s your health that’s at stake, or at least your hard earned cash anyway.

{ 3 comments… add one }

  • Kenny Roberts 8 November 2011, 3:28 am

    For some time I have enjoyed reading your blog, but I’ve got to say I was a little disappointed with part of this article.
    You see, I read it in the beginning of October while I was suffering from tennis elbow. The pain was even keeping me from my first love which is surfing. I tend to golf when the waves aren’t very good and by the end of summer I started developing some serious pain. I tried all the standard treatments (rest, ice and tons of Motrin) and admit I might have pushed it a bit, but I started to get really frustrated that it was getting worse. I definitely didn’t want to resort to steroid injections, but I was getting desperate.
    After researching on the internet, I found the Tendlite website. I am always cautious and skeptical about buying things online that make big claims, but I read a lot of their information and thought it sounded pretty good. I work in pharmaceuticals and hadn’t heard much about light therapy so I went outside the tendlight site to do my own research. As it turns out, there is a lot of research out there that supports lots of different types of light therapy.
    So I bought it, but a couple days later I read this article you wrote calling it out as a scam! Immediately, I felt like I just got taken for a ride for buying this thing. I was going to try to cancel my order but it had already shipped and I saw that I had a month to get a refund anyway. It came to my house a day or two later and I decided to give it a shot.
    The damn thing worked!! I was so relieved that I didn’t get suckered after all. I felt pain relief right away, and even let a surf buddy use it on his neck and shoulder. He said it worked too. All I can say is that I don’t know if you’ve ever tried it, but I’m glad I bought it before I read your article or you would have talked me out of it and I’d probably still be hurting!
    I didn’t notice all the spelling errors on the Tendlight site so they must have fixed them, but the fact that it was FDA approved made a huge influence on my decision to try it. Working in the pharmaceutical industry, I know how tough the FDA is when it comes to proving something is safe.
    So bottom line, I really like your website, which has a lot of great information, but I’m glad you were wrong on this one.
    Best regards,
    Kenny R.

  • Colin McNulty 8 November 2011, 9:52 am

    Thanks for your comment Kenny, and I’m glad you found a way to treat your elbow. It’s fair to say that I haven’t tried the Tendlite, so if you say it works for you, I’ll take your word for it.

    Re FDA Approval, the web is replete with articles about how worthless FDA Approval is, eg the New York Times. Even the FDA’s own website says:

    “the PMA applicant must provide reasonable assurance of the device‚Äôs safety and effectiveness.”

    To be clear, that’s approval just to market the product in the US, and “Reasonable assurances” on an application form does not fill me with much confidence. “Yeah sure it works, honest guv’!” Besides, the Tendlite is likely a Class I device, and so would be exempt from the requirement to register with the FDA, which says to me that the manufacturers have done it voluntarily, purely for marketing purposes. That would explain why they make such a deal of advertising the fact. As for the Amazon reviews, I’d bet my boots most of them were fake. So I’m sorry but I stand by my view that it blips my bullshit meter (excuse my French).

    Having said all that, I’ve been wrong about things before and accept that I might be wrong about this. I look forward to seeing other people’s comments on their experiences with the TenDLite too.

  • Liz 19 January 2014, 7:32 am

    Hi
    I found this blog as I was searching for the lumen rating for my Tendlite. I am looking at the chance to buy a couple of cheaper red LED lights to keep around the barn and in the car. Why? Because I bought the Tendlite after looking into photonic, and I am very pleased with the results. I want to use it for the animals as well as my family but don’t want to risk losing or damaging it. That said it’s pretty tough. Since it arrived my husband’s arm, sore for 10 weeks and in constant use due to the nature if his work, has improved from “I think I am going to have to go to the physio. This is creaking and b****y hurts” to “Oh my arm, that’s fine now” so from 10 – O on the nanometer! We continued treatment for a couple if day’s after 0 to be sure. My rotor cuff, also chronic, is less painful. A back twinge was stopped dead in it’s tracks. My husband has signs of some new growth on his bald pate. Best of all my horse (no placebo effect for her) is flexing her arthritic hind legs more easily despite vile winter weather and no change in her low level of analgesics. When I tell you that we have our own three horses we work with every day, rain or shine, no rest or let up, and my husband is training as a hoof trimmer so back, arms,legs etc take a huge hammering, you will see that we are not rest and recuperate folks.
    I certainly understand your reservations about spelling errors etc. but the customer service, communications and product quality have made me a happy customer. It does seem irresponsible of you to dismiss something as a scam without actually having knowledge or experience of that product. Especially.in the case of a protocol with no harmful side effects. A little research on the science of photonic would have shown that there is much credible evidence to support red light (600-670nm) therapy. The cost of the item is mostly to do with build quality and resultant reliability. I know cheaper devices can do the same job but am not going to expect any longevity from them.
    Please try to be objective when referring to products you have no direct knowledge of in case you deny someone the chance of discovery. Regards
    Liz

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