Regenerative Medicine for Tennis Elbow


By David Levi M.D.

Tennis elbow is a troubling condition, not just for athletes, but for many individuals struggling with elbow pain.  Tennis elbow occurs when the tendon which attaches to the outside part of the elbow mildly degenerates and develops small tears.  This tendon attaches to the top forearm muscles which lift your wrist and fingers.  Activation of these muscles will transmit forces through the degenerated tendon and cause pain.  Simple activities such as turning a key or lifting a carton of milk can cause pain when the tendons of the elbow become worn.


Treatment for tennis elbow, also called common extensor tendinosis, include: bracing, physical therapy, dry needling, medication, icing, and, in difficult cases, injections.  Steroids into or around the tendon have been the injection of choice for the last 25 years.   More recently, however, studies have shown that patients who undergo steroid injections for this issue tend to do worse in the long run than those who did not have the steroid injection.  This is because when steroids are injected directly into the tendon, they can weaken the tendon.  Additionally, ongoing use of nonsteroidal anti-inflammatories can interfere with tendon healing and prolong recovery.  NSAIDS also interfere with the effectiveness of PRP injections.


The ideal approach to treating tennis elbow is to implement an intervention that helps heal the degenerated tissue. Regenerative treatments, such as platelet rich plasma (PRP), have shown great promise in this area. A high concentration of growth factors is easily obtained from the patient’s own blood sample.  This concentrate is then injected directed into the damaged tissue as visualized under ultrasound.  Platelet rich plasma (PRP) treatment has been shown in multiple studies to be highly effective for tennis elbow.  And while the healing process does not occur immediately (often requiring several months for significant improvement) and the injections can cause some immediate discomfort, the benefits of PRP appear to be very effective and long lasting, often resulting in a true “cure” for this troubling condition.   Several of the physicians at APM Spine and Sports have a great deal of experience using this biologic healing therapy as well as a high level of expertise in using diagnostic musculoskeletal ultrasound to target injection sites.  The combination of expertise and experience make APM Spine and Sports a great choice when you are faced with a nagging painful elbow.  We look forward to helping you or your friend in need.


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