Sports Medicine | PRP for Tennis Elbow
Tennis elbow is a painful condition caused by an injury to the tendon of the elbow which can happen due to overuse or stress. It is a common condition where the outer part of the elbow becomes sore or tender. It is commonly seen in tennis players and hence the name “tennis elbow”.
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Tennis elbow is a common condition seen in the age group of 30 – 50 years; however, persons of any age group can be affected. It affects about 1 – 3% of general population. Almost half of all tennis players develop this condition, and the injury is more common in men than in women. It usually occurs in people who participate in recreational activities (especially racquet sports) and whose occupation involves repetitive and vigorous use of the forearm muscle like painters, plumbers, gardeners, and carpenters.
Tennis Elbow Causes
Tennis elbow is created due to a tear of tendon of the elbow, and is likely caused because of repetitive movement of the wrist. When the tendon is weakened due to recurring activity (like swinging a tennis racquet), tears can form leading to a swollen elbow coupled with pain. Most of the cases have only a partial tear.
Tennis Elbow Symptoms
Initially you may have pain on the outside of the elbow. It may worsen during grasping or holding an object during sports. Stiffness of the elbow is noticed with persistent pain especially during morning hours. Difficulty in performing simple tasks such as shaking hands, holding a racquet, or opening the door are common signs of tennis elbow.
Tennis Elbow Diagnosis
Your physician will diagnose your condition after asking you relevant questions on the how your pain occurred. He may ask you about your occupation and your sports participation. He may gently press on the outer side of elbow to see if you have pain. He may ask you to straighten your wrist and fingers to observe if this causes you pain. If you have tennis elbow, then doing these simple tests will give you pain. X-rays do not diagnose this condition, but if your doctor suspects fracture or arthritis, he may order xrays as well. Larger investigations like a MRI scan and a nerve conduction study are rarely needed.
Tennis Elbow Treatment
When you start noticing pain in the elbow, you may try reducing the amount of physical activity and try giving rest to your elbow. Your doctor also may advise you to decrease the activities that cause your pain. Application of ice on the affected area for about twenty minutes two to three times a day can potentially reduce swelling and pain to the elbow.
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Your physiotherapist may suggest specific wrist exercises to strengthen the muscles of the wrist. He may perform an Ice massage treatment to the elbow and he/she may utilize muscle stimulating techniques to stimulate healing of muscles. A counter force brace can be used to wrap on the forearm to reduce pain and allow rest to the muscles and tendons. Some doctors may also use shock wave therapy that sends sound waves to muscles in order to promote healing.
If you are involved in sports, your doctor may also arrange to check your sports equipment. Modifications of the racquet size, racquet material, string tension, backhand technique, and grip will help correct the condition. Stress on the forearm can be reduced by using stiffer racquets and looser-strung racquets.
Non-steroidal anti-inflammatory medications (NSAIDs) may be prescribed to reduce pain and swelling. Steroidal injections may also be given to reduce pain. However, these do not provide long term benefits.
Surgery may be considered if the patient does not respond to above mentioned treatments. Surgery may be considered as an initial form of treatment if the patient is a high profile athlete. Surgery is considered based on the scope of the injury, general health, and personal needs of the patient. Surgical procedures for tennis elbow involve removal of the diseased muscle and reattaching healthy muscle back to bone. It is usually performed as an outpatient surgery. Several months of rehabilitation and working with a physiotherapist is required following the surgery.
Goals of rehabilitation include identifying possible causes of the injury and avoiding them in future. Stretching and strengthening exercises of the wrist and forearm are taught to the patient. It is very important to continue the exercises to reduce the risk of recurrence of the condition.
PRP for Tennis Elbow
PRP(platelet rich plasma) treatment is becoming one of the most effective treatment options for tennis elbow sufferers. While there is still some controversy surrounding its use for other physical ailments, many in the medical community are convinced of its merits for treating this particular injury.
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PRP is an effective way to treat tennis elbow because it helps to speed up the healing process and has potential to aid in new tissue formation. Tendons receive very little blood. As a result, they tend to heal very slowly. By injecting concentrated platelets and growth factors into this area, this specific injury has a good probability of healing properly.
There have been a number of studies which support the idea that PRP is an acceptable method for treating tennis elbow. The studies have been small and more research will need to be done. However, the results have been very promising and some doctors swear by the procedure for this condition.
Many medical professionals believe PRP therapy to be superior to corticosteroid shots. Corticosteroid shots mask pain but they don’t promote healing. They may even cause further damage the more injections you recieve. For this reason, they are losing favor in some medical professions. PRP, conversely, does promote healing, which can potentially make it a better long-term option.
A physician may choose to use PRP to treat tennis elbow rather than cortisone shots or some other form of treatment, when he or she is more interested in the long term health of the patient and not in the short term relief of pain. There, however, may be instances when an individual needs to quickly minimize pain so that they can return to their sport as quickley as possible. In these cases, an injection of cortisone may be the best option. However, for those looking for a long term solution, PRP is a better option because its use promotes healing instead of breaking down your soft tissue. The same is true of those with tendon degeneration and long-time sufferers. PRP may be a better solution.
A study performed to compare the use of PRP therapy with corticosteroid shots to treat tennis elbow found that those who received corticosteroid shots experienced quicker pain relief. However, after 26 weeks, the people who underwent PRP therapy had less pain. Their conditioned also approved over the next year. PRP therapy patients reported an eight-four percent improvement in disability and a sixty-four percent improvement in pain. Patients who received corticosteroid shots didn’t fare as well. They reported only a seventeen percent improvement in disability and 24% improvement in pain.
Surgery is another option for those with tennis elbow. However, it can be painful and the recovery process can be lengthy. There are also no guarantees. Sometimes, the pain and discomfort of tennis elbow doesn’t subside even after surgery. Nerve damage and the inability to fully straighten your arm is definately a risk. Those without health insurance will likely find surgery to be expensive and therefore, not a realistic option. PRP is much less invasive and oftentimes bears the same results as surgery but without the risks.
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Cost of PRP treatment
PRP Therapy generally costs between 500 and $1500, depending on what size prp kit is used. This isn’t cheap but the price of the procedure isn’t excessive. One major drawback is that not every insurance company covers it. Therefore, it might end up being an out-of-pocket expense for patients who would like undergo PRP therapy but whose insurance companies won’t pay for it.
PRP for Tennis Elbow FAQ section
- How does PRP Therapy help cure or treat tennis elbow?
- Which is a better treatment option for tennis elbow and why is it a better option of treatment?
- What are the advantages of PRP Therapy?
- How much does PRP Therapy cost?
- Will insurance cover PRP Therapy?
PRP Injection Protocol and Procedures
Tennis Elbow Complications
If left untreated, tennis elbow can result in chronic pain especially during lifting or gripping objects. The condition will not improve if you use your arm too strenuously before the elbow has healed.
Tennis Elbow Prognosis
Some patients affected with tennis elbow respond to conservative methods of treatment. If surgery is performed, they can return to athletic activity in about four to six months after surgery. Failure to follow a proper therapy plan leads to a 70% chance of recurrence.
Tennis Elbow Prevention
Avoid physical activity that might have caused you pain. Rest the elbow if pain is noticed during bending or straightening. Use appropriate techniques and movements during activity. Use a counter-force brace during activities that require grasping or twisting arm movements. Employ stretching and strengthening exercises to keep yourself fit. Adjusting the racquet size is advised for tennis players.
Questions your doctor may ask you about your condition on your first doctor visit
- How long have you been living in pain? When did you first notice pain? Is it getting worse day to day?
- What is your occupation? Are you involved in recreational sports?
- Are you still able to perform your sports or work at a satisfactory level?
- Have you tried any home treatment for your condition?
- Have you tried any medicines? If yes, has it helped?
- If you practice sports how long do you practice and what kind of sports do you play?