Houston Methodist. Leading Medicine

Elbow FAQ

Question:

I have tennis elbow (really from playing too much tennis). I've been told my treatment options include: rest, wearing a brace, physical therapy, steroid injections, or something new called plasma injection. What do you recommend? I don't really know enough about each one of these to pick one.

Answer:

Tennis elbow causes pain that starts on the outside bump of the elbow, the lateral epicondyle. When you bend your wrist back or grip with your hand, the wrist extensor muscles contract. The contracting muscles pull on the extensor tendon. The forces that pull on these tendons can build when you grip things, hit a tennis ball in a backhand swing in tennis, or do other similar actions. Tennis elbow (also known by its medical term: lateral epicondylitis) is not limited to tennis players. The backhand swing in tennis can strain the muscles and tendons of the elbow in a way that leads to tennis elbow. But many other types of repetitive activities can also lead to tennis elbow: painting with a brush or roller, running a chain saw, and using many types of hand tools. Any activities that require a strong grip and repeatedly stress the same forearm muscles can cause symptoms of tennis elbow. Treatment is broken down into two phases: acute and chronic. If this is your first bout with tennis elbow, then you may be in the acute phase. Rest, activity modification, and possibly bracing to protect the healing tendons are usually advised. Pain relievers may be recommended but the use of anti-inflammatories has come under question. Letting the body mount an inflammatory healing phase without interfering is advised by some experts. Physical therapy combined with bracing has been shown to benefit the majority of patients treated this way. For those individuals who have had tennis elbow before without improvement using these treatment principles, steroid injections was once the next step. But studies have repeatedly shown that this type of injection therapy only provides temporary pain relief. Symptoms return and patients experience a recurrence of the problem. That's where the plasma injections come in. Platelet-rich plasma (PRP) injections may be recommended for someone who has chronic tennis elbow that has not responded to conservative care but who does not want to have surgery. The platelet-rich plasma (PRP) releases growth factors into the soft tissues. The result is a faster, more effective healing response. Studies have shown this treatment is safe, easy, and effective. Reduced pain and improved function last for months up to two years or more. To find out what's best for you, see a medical doctor. A sports medicine physician or orthopedic surgeon will be able to evaluate you and make a recommendation as to the best treatment for your particular problem. Taco Gosens, MD, PhD, et al. Ongoing Positive Effect of Platelet-Rich Plasma Versus Corticosteroid Injection in Lateral Epicondylitis. In The American Journal of Sports Medicine. June 2011. Vol. 39. No. 6. Pp. 1200-1208.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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