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when is it time for a cortisone shot for elbow tendonitis?

when is it time for a cortisone shot for elbow tendonitis?

I have been suffering from (R) elbow tendonitis for at least 6 months. I have tried Naproxyn, rest, heat, ice, pain relieving gel, Tyl#3, and it is just not going away. The pain is now radiating down my forearm and into my hand. I had similiar episode 3 years ago with (L) that eventually required surgery and has never bothered me since. I did go through 3 injections prior to the surgery and each time it helped for a short time. I am leery of getting steroids as I know they can do more damage than good but I am oh so tired of this. I have not injured it that I know of although in Feb 07 I fell down a flight of stairs and broke 2 fingers in that hand so I am wondering if it is just arthritis from that?? any suggestions on what else to do?
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454186_tn?1284987660
1) it's not arthritis,still is elbow tendonitis
2) 3 yaers ago,L elbow has never bother you,after episode,that's because it in early stage.in fact ,R elbow suffered it in same time,just isn't so sensitive.
3) so R elbow tendonitis is very chronic condition,Clinically ,only two option seem more effective ,One is surgery,another is intensive needles (something like micro-surgery therapy,about 30-40 needles put in some sensitive point in elbow)
4) Do you understand what  pathology of elbow tendonitis is?
Good luck!
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415109_tn?1304893782
Thanks for your comments. I have never heard of intensive needles. I do have osteoarthritis according to my bone scan from about 3 years ago that is why I was wondering if it could be arthritis getting that joint. I do understand pathology of elbow tendonitis as I researched it a lot before having the L elbow done. I guess its time to see the orthopod huh! I live in Central OR, moved from Portland,OR where I had a great ortho guy but don't know anyone in Bend area. Are you familiar with any in the area or do you have a list of good ones to choose from? mser
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