Let’s talk tennis elbow, also known as lateral epicondylitis, also known as common extensor origin tendinopathy. That’s a mouthful, so let’s break it down. Tennis elbow is actually the most common cause of pain on the outside of the elbow in human beings. Although about 50% of tennis players will deal with this at some point, they make up a relatively small fraction of people who suffer from this. In fact, estimates as high as 1 to 3% of the total population get affected with this at some point. People ask why, and it often has to do with the fact that tendons, which are structures that connect a muscle to bone, lose some of their small blood supply as we age. Making sense that most of the people who suffer from this, although a range of 20 years of age to 65 is generally seen, happen to usually be in their forties and fifties. And yes, if you work in manufacturing, retail, or in construction, you’re at risk. Why? Diseases that cause repetitive motion of the forearm and rest tend to predispose people to getting tennis elbow. When we find somebody who’s been struggling with this disease, they often have symptoms of pain around the outside of the elbow, pain with gripping, lifting something, extending their wrist, or sometimes even just shaking hands or opening a door.
So how do we help people get past it? Traditionally, people were prescribed courses of physical therapy and sometimes anti-inflammatories by mouth. Other treatments included bracing, sometimes at the elbow, and you’ll find a tennis elbow strap on Amazon very easily, or even counterforce bracing across the wrist. People who failed these treatments were often offered steroid injections. Although the evidence for steroid injections is not great and usually only provides temporary relief. Some severe cases were then taken to surgery, but not everybody is looking for a surgical fix to their problem if they have a less invasive solution. Enter PRP. PRP stands for platelet rich plasma. Although it’s considered a new and innovative technique, we now have over five randomized controlled trials, which is the highest standard of evidence in medicine, supporting the use of PRP for tennis elbow. Essentially what that means is a patient comes in, they get their blood drawn and platelets, which are special cells that exist within the bloodstream, are concentrated down to a very small volume, and then under imaging guidance, often with ultrasound, put directly back into the part of the tendon that is either disorganized or chronically scarred or injured. The long-term results of this treatment are fantastic. Ask your doctor if you wonder whether PRP can help your tennis elbow.