Do steroid injections help tendon pain from training?

Short answer

Only for a few weeks. Across 41 trials, pain clearly dropped at first but the effect reversed over time, and among 165 people with elbow pain, 54% relapsed within a year, more than 4 times the 12% on a placebo injection.

Do steroid injections help tendon pain from training?
'One shot → inflammation calms down → back to training' — is that right?
When an elbow or shoulder tendon hurts too much to train, many say one steroid shot fixes it fast. Plenty of people feel better right after the shot. We checked what happened weeks, months and 1 year after the injection.
It clearly works at first
At 6 weeks, the injection did best
An analysis that pooled 41 trials with 2,672 people found steroid injections cut pain more than other treatments in the short term. In a trial that split 198 people with elbow pain into injection, physiotherapy or wait-and-see, the injection group also did best at 6 weeks.
But it reversed weeks later
47 of the 65 who improved got worse again
In the same 198-person trial, 47 of the 65 people (72%) who had improved by 6 weeks with the injection got worse again, and at 1 year they did worse than the physiotherapy group. In the analysis of 41 trials, elbow pain did better with no treatment at all over the medium and long term.
Relapse at 1 year was more than 4 times higher
54% relapse vs 12% with a placebo injection
165 people with elbow pain got either a real steroid injection or a placebo injection. At 1 year, 83% of the injection group had fully recovered or improved a lot, vs 96% with the placebo injection. Within 1 year, 54% of the injection group had pain come back, vs 12% with the placebo injection.
In the shoulder, the effect was small to begin with
At 3 months, no difference from a placebo injection
In an analysis of 726 people with shoulder tendon pain, the injection reduced pain a little at 4–8 weeks, and at 3 months there was no difference from a placebo injection. 5 people had to be injected for 1 to have a short break from pain. A 2025 analysis of 1,785 people also found injection alone was no better than exercise therapy.
Heel pain relief lasted only a month
No difference after 1–6 months
In 8 trials with 724 people with heel pain, the injection reduced pain a little up to 1 month, with no difference at 1–6 months. Serious side effects were rare: 1 in 991 people (0.1%) had a tendon rupture, and 2 of 699 people given heel injections had the tissue under the foot rupture.
Bottom line: a shot only buys a few weeks
For the elbow, it was worse at 1 year
Steroid injections reduced pain for a few weeks. For the elbow, relapses afterward made results worse at 1 year, and for the shoulder and heel there was no difference at 1–6 months. What a shot gives you is a few weeks of less pain.