Understanding Your Tennis Elbow
By: Dr. Tennant, Dr. Sherfey, Dr. Nasser
Lateral epicondylitis, commonly known as tennis elbow, is a prevalent condition characterized by pain and tenderness on the outer part of the elbow. This discomfort arises from overuse or repetitive strain, leading to microtears in the tendons that attach to the lateral epicondyle of the humerus. While the term "tennis elbow" suggests a connection to racquet sports, the condition can affect anyone engaging in repetitive arm and wrist activities, such as painters, plumbers and carpenters.
The pathophysiology of lateral epicondylitis involves degeneration of the extensor carpi radialis brevis (ECRB) tendon. Repeated stress leads to microscopic tears and subsequent tendinosis, characterized by an imbalance between tendon breakdown and repair. This degenerative process results in pain and functional impairment, making routine tasks challenging for affected individuals.
Traditional management strategies for lateral epicondylitis include rest, nonsteroidal antiinflammatory drugs (NSAIDs), physical therapy and corticosteroid injections. However, these approaches may offer only temporary relief and do not address the underlying tendon degeneration. In recent years, regenerative treatments such as platelet-rich plasma (PRP) and stem cell therapy have garnered attention for their potential to promote tendon healing and provide more durable symptom relief.
PRP therapy involves the extraction and concentration of platelets from the patient's own blood, which are then injected into the affected tendon area. Platelets are rich in growth factors that play a crucial role in tissue repair and regeneration. Several studies have investigated the efficacy of PRP in treating lateral epicondylitis. A systematic review and meta-analysis published in the Orthopaedic Journal of Sports Medicine evaluated the effectiveness of PRP in lateral epicondylitis treatment using minimal clinically important difference (MCID) values as a reference. The analysis included 26 studies and concluded that PRP appears to be an effective form of treatment, with both leukocyte-rich and leukocyte-poor PRP systems meeting MCID thresholds for pain and functional improvement.
Stem cell therapy represents another regenerative approach under investigation for treating lateral epicondylitis. Stem cells have the potential to differentiate into various cell types, including tenocytes, which are essential for tendon repair. While the theoretical basis for stem cell therapy is promising, clinical research in this area is still in its early stages. Limited studies have explored the efficacy of stem cell injections for lateral epicondylitis, and more rigorous, large-scale clinical trials are necessary to establish their safety and effectiveness.
In summary, lateral epicondylitis is a degenerative condition resulting from repetitive stress, leading to tendon microtears and pain. Regenerative treatments like PRP have shown potential in promoting tendon healing and providing symptom relief, with several studies reporting positive outcomes. However, the evidence is mixed, and some trials have not demonstrated significant benefits. Stem cell therapy remains an area of active research, with further studies needed to determine its role in managing tennis elbow. As with any medical intervention, it is essential for patients to consult with healthcare professionals to discuss the most appropriate treatment options based on individual circumstances and the current evidence base. Our physicians at Regenerative Orthopedic Solutions (ROS) specialize in these advanced regenerative treatments, offering patients cutting-edge options for pain relief and tendon healing.
Written by our fellowship-trained physicians at Regenerative Orthopedic Solutions; Dr. Tennant, Dr. Sherfey, & Dr. Nasser. With over 60 years of combined experience in orthopedic trauma, joint replacement, sports medicine, pain management and regenerative therapies. Fellowship-trained at prestigious institutions, our physicians have treated thousands of patients with innovative techniques.
