Tennis Elbow Pain Treatment by Ray Sahelian, M.D. Tennis elbow therapy
Tennis elbow is an overuse injury to tendons around the outer side of the elbow. As the name implies, it often arises in racquet-sport enthusiasts, but can also result from other repetitive arm motions, such as using a screwdriver, hammering or painting. Known medically as lateral elbow pain, tennis elbow generally improves on its own. However, it may persist in a small percentage of people, who may even require surgery. Tennis elbow strikes 1 percent to 3 percent of the general population each year,
Tennis Elbow Treatment
There are many treatment options for tennis elbow, including rest, anti-inflammatory pain medications, braces and injections of corticosteroids. However, the effectiveness of some of these tactics is questionable, and some people continue to suffer chronic pain that may eventually require surgery. For relieving painful tennis elbow, there seems to be no difference between the clinical or cost effectiveness of wearing a brace or participating in physical therapy -- or a combination of the two. So the question of which approach is best for treating tennis elbow, remains unanswered. Several studies of different methods for tennis elbow treatment, including corticosteroid injections and a "wait and see" approach as well as bracing or physical therapy, have been unable to show that any one approach is more effective or cheaper than any other
Steroid Injections and Tennis Elbow
Steroid
injections on average produce a 50% reduction of pain after three months. There
is debate as to whether steroid injections offer a benefit greater than other
tennis elbow treatment options.
Shock Wave Therapy for Tennis Elbow
So-called extracorporeal shock wave therapy (ESWT) has been tried for tennis elbow, in which shock waves are focused on the problem area, with or without local anesthesia. ESWT is believed to work by causing microscopic injuries to the affected tissue that stimulate the healing process. There is little "high-quality" evidence for the benefits of many tennis elbow treatments, including shock wave therapy. A review of many studies published regarding shock wave therapy and tennis elbow found shock wave therapy was no better than placebo.
Tennis elbow surgery
Long-term relief and improved function may be possible in some chronic tennis
elbow sufferers with arthroscopic release. Arthroscopic release is the placing a
tiny video camera inside the elbow joint, and then releasing and removing the
diseased tissue from the inside of the joint. It is all done through several
small incisions."
Platelets for Tennis Elbow?
A simple therapy that uses the natural healing powers of blood cells called
platelets could offer a new treatment for chronic cases of tennis elbow.
The one-time treatment involves drawing blood from a patient's arm and spinning
it through a centrifuge in order to create a sample with a high concentration of
platelets. This blood derivative, called platelet-rich plasma (PRP), is then
injected directly into the injured elbow tendon. In a study, the 15 patients who
received the injection showed a 60 percent improvement in pain symptoms after 8
weeks. Two years later, nearly all of the patients were essentially pain free.
Platelets contain powerful growth factors. Platelet
growth factors initiate a repair process in damaged tendons, which may include
recruiting other cells, such as bone marrow stem cells, to the injured area.
Tendons connect muscle to bone and generally have a relatively poor blood
supply. Injecting an army of platelets directly into the tendon overcomes this
barrier. PRP therapy is not yet widely available, however, since larger, more
rigorous clinical trials have not yet been completed. This pilot study included
20 patients with chronic tennis elbow that had proven resistant to standard
therapy; 15 received an injection of their own platelets, and 5 received an
injection of pain medication. Eight weeks after treatment, the PRP group
reported an average 60 percent improvement in their pain, versus only 16 percent
in the comparison group. Three of the five patients in this latter group
subsequently dropped out of the study or sought other treatment. At the final
follow-up two years later, 93 percent of PRP patients said they were "completely
satisfied" with the therapy, and had resumed most of their work and sports
activities. American Journal of Sports Medicine, November 2006.
Tennis Elbow Questions
Q. Would serrapeptase
be helpful for tennis elbow?
A. We have come across no research regarding serrapeptase and tennis elbow.
Q. I am a 48 year old male in healthy condition. I am currently taking Passion
Rx and R-alpha-lipoic acid. I have tendonitis in my right elbow. I have had 5
cortisone shots with little success. Are there any supplements I can take to
help reduce the inflammation and/or pain.
A. We have not seen any studies regarding the treatment of tennis
elbow tendonitis with the use of natural supplements. If anything could help it
may be Joint Power Rx but we have no feedback from users of this supplement in
regards to tennis elbow pain.