Tennis elbow (lateral epicondylitis) is a painful condition involving the tendon that attaches at the outside bony prominence of the elbow or lateral epicondyle. Tennis elbow is a type of overuse injury that results from repetitive motion of the wrist and arm often from overuse due to particular jobs and activities.
Because of the name, you might think that tennis elbow is strictly an injury that athletes develop. But that isn’t so. Tennis elbow can occur in people whose jobs require repeat motions, such as painters, secretaries, accountants, carpenters, and guitarists. This condition is often described as an overuse injury.
Overuse injuries are activity-related injuries linked to repetitive stress placed on the tendon, ligament or other joint structure. Doing too much of the same activity strains the tendons, ligaments, and other soft tissue structures of the elbow. Using poor or improper technique while training or poor form when painting can overload the muscles, tendons, and ligaments, and cause an overuse injury.
The pain involved in tennis elbow is usually noted where a tendon of the forearm attaches to the bony bump at the outside of the elbow. The pain may radiate from the outer elbow into the forearm and wrist. These symptoms may make daily activities difficult such as turning a doorknob or picking up, holding, and gripping objects.
Chronic elbow pain may be related to ligament, muscle, and tendon injury. In order to resolve the problem, all of these areas need to be addressed for alleviation of the pain.
When elbow ligaments are involved, they may be frayed, torn, or otherwise weakened. Why is it important to address the ligaments if tennis elbow is a tendon problem? Ligaments are dense bands of connective tissue that attach one bone to another. They hold the bones in place, and allow for a strong, stable base upon which the muscles contract and move the joint. When a tendon is injured, there is often ligament involvement as well.
When the ligaments are injured or weakened, they can cause strain on the tendon and other joint structures. This allows for excessive elbow movement and instability. In this cycle of instability, the tendons will attempt to hold the muscle to the bone, increasing stress, and increasing the possibility of injury to the tendon.
Those with tennis elbow often try to manage the pain with over-the-counter medications and/or conservative therapy to stabilize the elbow such as with a brace. Resting the elbow is another way sufferers attempt to find relief in order to continue to work or participate in activities.
Recommended conventional treatments for tennis elbow often include NSAIDs, physical therapy, bracing, and taping. Unfortunately, these treatments may only provide temporary relief but they are not reparative in nature.
Symptoms may be suppressed with pain medications or calmed down with bracing. However, a sleeve, for example, will only give a false sense of security while only temporarily helping the sufferer to function. If the pain continues, and becomes chronic, the individual requires a treatments that will repair the involved tendon and ligaments.
The journal Prosthetics and Orthotics International (1) examined the popular counterforce brace in people with problems of lateral elbow tendinopathy and found that physical therapy had better results.
The US National Institutes of Health Clinical Trial website says: “Despite its promise, there have been no high-quality studies evaluating the efficacy of arthroscopic tennis elbow release, bringing the actual efficacy of this procedure into question.” (2)
There’s Another Way and It Does Not Require Surgery!
Regenerative Orthopedics is a non-surgical treatment that effectively repairs the tendons and ligaments involved in tennis elbow. Prolotherapy is one type of Regenerative Orthopedics and studies show its effectiveness in treating tennis elbow.
Prolotherapy is an injection technique that works to regenerate the degenerated tendon. The injection of simple dextrose mimics the natural healing response and stimulates healing growth factors to repair the tissue.
Researchers published a study in the American Journal of Physical Medicine & Rehabilitation that evaluated Prolotherapy for tennis elbow. They concluded: “Prolotherapy resulted in safe, significant improvement of elbow pain and function compared with baseline status and follow-up data and the wait-and-see control group. This pilot study suggests the need for a definitive trial.”(3)
A study of 84 patients with tennis elbow who were treated with dextrose prolotherapy had statistically significant reductions in pain levels. (4)
Prolotherapy is effective for tennis elbow! It works because it boosts the body’s healing abilities naturally. And, it works because it addresses the problem by repairing the injures soft tissue. Plus, it works because it reduces or eliminates the symptoms.
Fortunately, Prolotherapy and other Regenerative Orthopedics, such as PRP and Stem Cell Therapy, all strengthen the involved ligaments and tendons. These therapies stabilize the elbow, strengthen the elbow, address the instability, and put an end to the pain and symptoms of tennis elbow. Recommendations may be made for PRP and/or Stem Cell in more advanced cases, but all treatments would include Prolotherapy.
If tennis elbow is a condition you are currently facing, please reach out and give us a call. We would be happy to help you become symptom free.
Shahabi S, Bagheri Lankarani K, Heydari ST, Jalali M, Ghahramani S, Kamyab M, Tabrizi R, Hosseinabadi M. The effects of counterforce brace on pain in subjects with lateral elbow tendinopathy: A systematic review and meta-analysis of randomized controlled trials. Prosthetics and Orthotics International. 2020 Jul 8:0309364620930618.
Kroslak M, Murrell GAC. Surgical Treatment of Lateral Epicondylitis: A Prospective, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial. Am J Sports Med. 2018 Mar 1:363546517753385. doi: 10.1177/0363546517753385.
Rabago D, Lee KS, Ryan M, Chourasia AO, Sesto ME, Zgierska A, Kijowski R, Grettie J, Wilson J, Miller D. Hypertonic Dextrose and Morrhuate Sodium Injections (Prolotherapy) for Lateral Epicondylosis (Tennis Elbow): Results of a Single-blind, Pilot-Level, Randomized Controlled Trial. Am J Phys Med Rehabil. 2013 Jan 3.
Shin J, Seo K-M, Kim D-K, Kim B-K, Kang SH. The effect of prolotherapy on lateral epicondylitis of elbow. J Korean Acad Rehabil Med. 2002;26:764–8.