Table 1 Eligibility criteria

Unilateral elbow pain for longer than six weeks

Pain severity equal or greater than 30 mm on a 100 mm visual analogue scale

Pain over the lateral humeral epicondyle provoked by at least two of: gripping, palpation, stretching of forearm extensor muscles and resisted wrist or middle finger extension

Reduced pain-free grip force

Age between 18–70 years

An acceptable understanding of written and spoken English

Willingness to comply with treatment and follow-up assessments

Exclusion criteria

Injection within the preceding 6 months

Course of exercise based physiotherapy program within the preceding 3 months

Concomitant neck or other arm pain that has prevented participation in usual work or recreational activities or necessitated treatment within the last 6 months

Evidence of other primary sources of lateral elbow pain including: exacerbation of elbow pain with neck movements or manual examination; pain localised over the radiohumeral joint, sensory disturbance in the affected hand

History of fractures within the preceding 10 years, elbow surgery, malignancy, inflammatory or arthritic disorder

Any medical condition which may contraindicate injection or exercise prescription

Pregnant or breastfeeding