Lateral Epicondylitis: What to Do When First-Line Treatment Fails to Relieve Lateral Elbow Pain

Lateral epicondylitis produces persistent pain at the lateral elbow that can prove resistant to initial management. When standard first-line interventions do not achieve adequate short-term pain relief, a defined second-line protocol guides the next clinical step.

Previous Treatment — Failure Condition

This protocol applies when corticosteroid injection at the lateral epicondyle, extracorporeal shock-wave therapy at the lateral epicondyle, or acupuncture has not achieved short-term lateral elbow pain relief within 4 weeks. These recalcitrant cases require a different approach.

Second-Line Approach — Partial Overview

The second-line protocol for recalcitrant lateral epicondylitis centres on a targeted injection-based intervention applied directly at the affected lateral epicondyle tendon, with the clinical goal of achieving short-term lateral elbow pain relief. The specific choice of agent, procedural detail, and full clinical algorithm are available in the complete structured regimen.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1155/2020/6965381

Local ABI has been proved effective and widely used for treatment of LE.
ABI works by initiating the inflammatory response around the affected tendon, which may result in cellular and humoral mediators to induce a healing cascade.
its indications should restrict to those recalcitrant cases when other modalities of treatment are less effective.
PRP has gained popularity in recent years in the treatment for LE.
Current evidence suggests that ABI can achieve good outcome in the short term; however, no benefit has been found in the medium- or long-term follow-up.

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