- Adam R Whatley Osteopath
Tennis Elbow (Epicondylitis)
TENNIS ELBOW - EPICONDYLITIS
Tennis elbow is a common condition where you have pain on the outer side of the elbow where the muscle tendons attach onto the bone. It is commonly caused by overuse and repetition, causing damage to tendons. The medical term for tennis elbow is 'lateral epicondylitis'. For most people with tennis elbow, the pain only occurs when they use their forearm and wrist, particularly for twisting movements such as using a screwdriver or opening a jar. However, for some people the pain is constant and can even affect sleep. Tennis elbow has also been associated with occupations that require vibration tool or even drivers. The pain may travel down your arm from your elbow towards your wrist. You may find it difficult to hold items such as a knife or fork, a cup or a pen, or to straighten your arm fully. Some people also notice a stiffness in the affected arm. Golfer's elbow is the name given to a similar condition that produces pain around the inner side of your elbow.
The most common overuse injury at the elbow. Commonly associated with racket sports and office workers due to repetitive tension on to the tendon.
Pain on outside of elbow
Pain on gripping
Pain on gripping with an outstretched arm
Most frozen shoulders improve over time, but it is a condition which is notorious difficult to treat. However, the pain and limitations of the stiff frozen shoulder generally require treatment. The treatment required depends on the severity of the pain and stiffness. These include:
Painkillers and anti-inflammatory medications only provide short term relief.
Osteopathic Treatment and physical rehabilitation aims to keep the elbow tendon strong, with further aims to reduce pain and weakness.
If conservative treatment fails then you may be offered a cortisone steroid injection into the area to help reduce inflammation and control the pain. However, it should be noted that these in most cases only offer short term relief and Is not a solution long-term. Furthermore, it should also be noted that steroid injection can infect cause tendon damage with repeated injections.
Platelet rich plasma (PRP) Treatment is a very popular natural non-surgical treatment aiming to restore function and reduce pain. Also, a popular form of regenerative medicine which is used to preserve and restore tendon health.
- REGENERATIVE MEDICINE. PLATELET RICH PLASMA (PRP) TREATMENT:
Platelet-rich plasma (PRP) is a very popular ortho-biologic treatment use in regenerative medicine. Ortho-biologics are substances that occur naturally in the human body. When extracted, concentrated and injected back into the body, these substances activate the body’s own healing mechanisms. PRP treatment is performed by taking a small sample of the patient’s blood, extracting the platelets are then further contacting them before they are used to speed up healing and recovery. PRP injections are very commonly used to facilitate the body’s self-healing mechanisms, and the clinical outcomes are very good. Furthermore, it is completely natural and associated with minimal downtime. PRP has been shown in scientific research to be very effective for treating multiple cases of tendonitis, especially tennis elbow. PRP has been shown in scientific research to be very effective for treating mild to moderate osteoarthritis, without the risks and expense of surgery. Most patients here at Dynamic Osteopaths & Regenerative Medicine report minimal discomfort associated with the injection. Also, go on to report significant improvement that occurs in the subsequent weeks. A recent study demonstrates that platelet-rich plasma treatment can produce collagen and growth factors, which increases stem cells and consequently enhances the healing.
Clinical evidence and studies:
The Effect of Platelet-Rich Plasma on Clinical Outcomes in Lateral Epicondylitis - https://www.arthroscopyjournal.org/article/S0749-8063(13)00853-0/fulltext
The effect of corticosteroid versus platelet-rich plasma injection therapies for the management of lateral epicondylitis: A systematic review - https://www.ncbi.nlm.nih.gov/pubmed/29561260
The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment - http://journals.sagepub.com/doi/10.1177/0363546517743746.
Autologous US-guided PRP injection versus US-guided focal extracorporeal shock wave therapy for chronic lateral epicondylitis: A minimum of 2-year follow-up retrospective comparative study - http://journals.sagepub.com/doi/10.1177/2309499017749986
Relationship of cytokine levels and clinical effect on platelet-rich plasma-treated lateral epicondylitis - https://www.ncbi.nlm.nih.gov/pubmed/28851099.
PRP & Tennis Elbow Comparison between Corticosteroid, Platelet Rich Plasma (PRP) and Xylocaine Infiltration for Lateral Epicondylosis (Tennis Elbow): A Prospective Randomized Study - https://www.omicsonline.org/open-access/comparison-between-corticosteroid-platelet-rich-plasma-prp-andxylocaine-infiltration-for-lateral-epicondylosis-tennis-elbow-aprosp-2167-1222-1000304.php?aid=73073
Treatment of patients with epicondylitis with PRP reduces pain and significantly increases function, exceeding the effect of corticosteroid injection - http://www.ijabmr.org/article.asp?issn=2229-516X;year=2017;volume=7;issue=2;spage=125;epage=128;aulast=Varshney.
A comparative study to evaluate the efficacy of platelet-rich plasma and triamcinolone to treat tennis elbow - https://www.ncbi.nlm.nih.gov/pubmed/28566783.
Platelet rich plasma versus steroid on lateral epicondylitis: meta-analysis of randomized clinical trials - https://www.ncbi.nlm.nih.gov/pubmed/28276986.
The Time Has Come to Try Intra-articular Platelet-Rich Plasma Injections for Your Patients With Symptomatic Knee Osteoarthritis - https://www.ncbi.nlm.nih.gov/pubmed/28259349
Further specific strengthening exercises can be adopted when tolerated
PLEASE FOLLOW LINK HERE FOR SPECIFIC ELBOW REHABILITATION FOLLOWING TENNIS ELBOW