Comparison of Intra-articular and Intra-tendinous Injections for Treatment of Lateral Epicondylitis

Lateral epicondylitis, commonly known as "tennis elbow" is a common cause of elbow pain encountered in primary care and specialty clinics. Although lateral epicondylitis is common, little consensus exists on the best way to treat it. Historically 80% of patients will get better with non-operative treatments (rest, NSAIDS, bracing and injections). In regard to efficacy of injections, recent large, prospective, randomized studies have shown minor improvements in the short term, but no long term benefits when compared to saline injection. Consistently, intra-articular injections have not been reported. The investigators suspect that elbow joint inflammation may be an underappreciated source of pain in lateral epicondylitis. The investigators' hypothesis is that patients receiving intra-articular injections will have greater improvement compared to patients receiving either no injection or an intra-tendinous injection.