I have a very persistent case of tennis elbow — probably from my work at a meat packing plant. I’ve tried a couple of steroid injections. They helped for about a week and then the pain started again. I’ve heard there’s a new blood injection treatment I could try but that it is more painful than the steroid injections. What can you tell me about this?

Lateral epicondylitis, more often referred to as “tennis elbow,” is a fairly common problem in the work place. Workers with strenuous jobs in various industries are often affected. And since an episode of lateral epicondylitis can last six months to two years, effective treatment is a must to keep workers on-the-job, productive, and earning a living.

But the best, most effective treatment for tennis elbow remains unknown. Many things have been tried including antiinflammatory drugs, exercise, bracing or splinting, injection therapy, and surgery. Short-term pain relief may be obtained but no long-term benefit has been reported.

Platelet-rich plasma (PRP) is a fairly new treatment procedure for tennis elbow. PRP refers to a sample of serum (blood) plasma that has as much as four times more than the normal amount of platelets and growth factors. This treatment enhances the body’s natural ability to heal itself. PRP is used to improve healing and shorten recovery time from acute and chronic soft tissue injuries.

According to some patients who have had both steroid injections and PRP injections, the platelet-rich plasma (PRP) injections are more painful than steroid injections. They seem to experience additional pain lasting up to three weeks in some cases. That may be because delivery of PRP requires five to seven pokes into the tissue as opposed to only one with steroid injections.

Studies show that steroid injection give the best pain relief and improved function in the first month after injection (compared with PRP or a placebo saline injection). At the end of three months, there is often no difference in treatment results between steroid injection and PRP for pain and disability.

Tendon thickness may increase with PRP (a positive benefit of blood injection therapy). Tendon (and skin) thickness often decrease (atrophy) with the steroid injection (a negative or adverse effect of steroid injections). The long-term benefits of PRP have not been proven yet. Researchers continue their efforts to find a successful way to treat tennis elbow for everyone!