THE QUESTION The burning elbow pain and weak grip of the condition nicknamed tennis elbow are often treated with steroid injections and physical therapy. How much do these treatments help?

THIS STUDY involved 165 adults, who averaged 50 years old and had lateral epicondylalgia, or tennis elbow, in one arm for at least six weeks. Participants were randomly assigned to one of four treatments: a corticosteroid injection with or without physical therapy, or a placebo injection with or without physical therapy. Physical therapy consisted of 30-minute treatments weekly for eight weeks, involving elbow manipulation and exercises, plus a daily at-home exercise routine. Participants were to refrain from strenuous activity for two weeks after the injection and then return to normal activity. People who had gotten a steroid injection fared worse in the year after treatment than those who'd been given a placebo, with fewer of them rated as completely recovered or much improved (83 percent vs. 96 percent) and more having a recurrence (54 percent vs. 12 percent). They also reported worse pain. Physical therapy was found to have no bearing on how people fared long-term. However, those who did not get a steroid shot but did have physical therapy reported short-term benefits, such as less pain in the first few weeks, and the lowest recurrence rate (about 5 percent).

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