Tennis elbow (also known as lateral epicondylitis) doesn’t always occur in tennis players. Anyone can develop tennis elbow. It is usually the result of overuse of the elbow. Not everyone who plays tennis or who engages the elbow in repetitive motions develops tennis elbow. There is evidence that abnormal healing responses combined with mechanical overload may be part of the problem.
Various treatments have been tried, combined, studied, and compared with no one single approach being successful for everyone. Based on current evidence, there is some agreement that a program of eccentric exercise should be included no matter what other treatment is used.
Eccentric exercises place the wrist extensor muscles in full contraction with motion to slowly allow the muscle to lengthen. A physical therapist can set you up on a program of stretching and eccentric exercises. The therapist will guide you through a gradual progression of movement and exercise during healing and recovery. Eventually you will need to retrain the muscles and tendons to fire normally during all motions and activities (not just eccentric lengthening).
Another newer treatment that has been shown beneficial for chronic tennis elbow is the use of platelet-rich plasma (PRP). PRP is the plasma (clear) portion of the blood with eight times the number of platelets as regular whole blood.
Platelets contain special growth factors that are normally released during a healing or tendon reparative process. Depending on how the platelet-rich plasma is prepared, there can be up to 25 times the normal number of growth factors available. Platelet-rich plasma has been shown to increase the number of cells needed to stimulate collagen production but without creating scar tissue. Collagen is the basic building material of tendons.
Some people get good results combining platelet-rich plasma injection with a follow-up rehab program as described. Others may have to work a bit longer to find the right combination of treatment that works best for them. This may include rest, acupuncture, steroid injection, or iontophoresis (a technique using a mild electrical current to push anti-inflammatory medicine through the skinto the sore area).
Sometimes nonsurgical treatment fails to stop the pain or help patients regain use of the elbow. In these cases, surgery may be necessary. The best thing to do is see your primary care physician, an orthopedic surgeon, or a physical therapist for an evaluation and treatment plan. Get started with conservative (nonoperative) care and see what kind of response you get before thinking or worrying about the potential for surgery.