Elbow Pain and Instability
Tennis Elbow (lateral epicondylitis) is a term for severe elbow tendonitis, or an inflammation, soreness, or pain on the outside (lateral) part of the upper arm near the elbow. It’s usually caused by a partial tear in the tendon fibers, which connect muscle to the bone. Symptoms include elbow pain that gradually worsens and radiates outside of the elbow to the forearm and to the back of the hand. Although, termed “Tennis Elbow”, anyone can experience this painful condition that results from constant and overuse of the tendon.
Patients with elbow tendonitis may not respond to the conventional treatments of wait, rest, and medicate for pain relief. For some patients still, this slow-track to healing is not in their schedule and they would much prefer getting on with their lives by fast forwarding the healing process. Platelet Rich Plasma (PRP) therapy extracts the healing platelets from your blood and then re-injects the Platelet-Rich Plasma into the injured elbow. In research doctors suggest Platelet-rich plasma offers a new option for the treatment of lateral epicondylitis. In a comparison of PRP and cortisone injections, doctors say PRP is a superior treatment option in the long-term.1
In another comparison study doctors examined autologous blood injections with added painkillers, cortisone and PRP. They found of the three options PRP injection improved pain with lower risk of complications.2 Recent research in the American Journal of Sports Therapies documented the positive effects of PRP on tennis elbow. Treatment of patients with PRP reduced elbow pain and increased function significantly, exceeding the effect of corticosteroid injection even after a follow-up of 2 years.”3
British doctors agree – research in the British Journal of Sports Medicine says cortisone should never be used and that injections therapies including PRP and simple dextrose Prolotherapy can be effective and excellent treatments for tennis elbow.4 So clearly these scientists found that PRP worked better for the patient than cortisone or painkillers. In some of the newest research reported in the surgical journal – Journal of Hand and Microsurgery doctors reviewed and presented their evidence on the effectiveness of PRP injections. They found PRP injections have an important and effective role in the treatment of elbow instability.5
In new research published in BioMed Research International doctors reviewing the medical literature found that the first studies on the more advanced treatment – stem cell therapy - showed promising results for elbow pain. For an explanation of stem cell therapy please see my article Stem Cell and PRP therapy for non-healing tendons. That same research also showed that patients who received a series of 3 separate Prolotherapy injections over 8 weeks had significantly improved pain scores and isometric strength at 16 weeks compared to placebo.
The Annular Ligament:
This ligament connects and stabilizes the two bones of the forearm, the ulna and the radius. Activities that involve rotation of the elbow, such as screwing in a light bulb, turning a screw driver, using a cork screw, puts a tremendous stress on this ligament. It especially includes those activities in sports where throwing is involved, or where an implement is used to drive a ball. Sometimes the pain in the annular ligament can refer itself down into the thumb, wrist and index and middle fingers, mimicking and sometimes leading to an incorrect diagnosis of carpal tunnel syndrome.
While an acute injury, like a fall, can be responsible for annular ligament injury, it is usually repetitive motion that does it. This type of elbow injury can last for months and is usually diagnosed under the umbrella term “tennis elbow.” “Golfer’s Elbow” is another umbrella term coined to describe elbow pain when flexing the wrist and hand are required as in activities such as grasping, clutching, and typing. It gets its name “Golfer’s Elbow” because the muscles and tendons required to hit a golf ball are the same ones used in the above named activity. The ligament involved in Golfer’s elbow is the ulnar collateral ligament (UCL) which holds the ulnar bone of the forearm to the bottom of the the upper arm bone (the humerus.) When this ligament is injured or weakened its pain can be felt on the inside of the elbow. Once determined that it is weakness or injury to the tendons or ligament that is causing elbow pain Stem Cell Therapy can be administered and the pain can be resolved.
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1. Yadav R, Kothari SY, Borah D. Comparison of Local Injection of Platelet Rich Plasma and Corticosteroids in the Treatment of Lateral Epicondylitis of Humerus. J Clin Diagn Res. 2015 Jul;9(7):RC05-7. doi: 10.7860/JCDR/2015/14087.6213.
2. Arirachakaran A, Sukthuayat A, Sisayanarane T, Laoratanavoraphong S, Kanchanatawan W, Kongtharvonskul J. Platelet-rich plasma versus autologous blood versus steroid injection in lateral epicondylitis: systematic review and network meta-analysis. J Orthop Traumatol. 2015 Sep 11. [Epub ahead of print]
3. Gosens T, Peerbooms JC, van Laar W, den Oudsten BL. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up.Am J Sports Med. 2011 Jun;39(6):1200-8. Epub 2011 Mar 21.
4. Dong W, Goost H, Lin XB, Burger C, Paul C, Wang ZL, Kong FL, Welle K, Jiang ZC, Kabir K. Injection therapies for lateral epicondylalgia: a systematic review and Bayesian network meta-analysis. Br J Sports Med. 2015 Sep 21. pii: bjsports-2014-094387. doi: 10.1136/bjsports-2014-094387. [Epub ahead of print]
5. Murray DJ, Javed S, Jain N, Kemp S, Watts AC. Platelet-Rich-Plasma Injections in Treating Lateral Epicondylosis: a Review of the Recent Evidence.. J Hand Microsurg. 2015 Dec;7(2):320-5. doi: 10.1007/s12593-015-0193-3. Epub 2015 Jul 8.