I see many movie stars who have BOTOX done on their faces. My doctor has recommended this as a treatment for my chronic tennis elbow. I thought BOTOX was to smooth out wrinkles and puff up lips. How does it help with tennis elbow?

Tennis elbow (also known as lateral epicondylitis) is a fairly common work- or recreational-related problem caused by repetitive motions (e.g., gripping, bending wrist back into extension). Sometimes the elbow feels stiff and won’t straighten out completely. Men and women are just as likely to develop symptoms of tenderness and pain that starts on the outside bump of the elbow, the lateral epicondyle.

The most common first-line of treatment is usually conservative (nonoperative) care. This can involve a form of treatment known as “benign neglect” or “watchful waiting.” Other treatment approaches include physical therapy, the use of nonsteroidal antiinflammatory drugs or NSAIDs, injection therapy, and sometimes surgery.

Injection treatment for lateral epicondylitis (tennis elbow) is usually with glucocorticoid (a steroid medication). Glucocorticoid has been around since the 1950s and has been studied the longest. Other types of injection therapies (including Botulinum toxin or BOTOX) are still fairly new (developed in the last 10 years or so).

In the few, small studies reported so far using BOTOX to treat chronic tennis elbow, there have been no serious side effects in any of the trials. As with any injection treatment, pain is felt at the time of injection and for a short time after injection. Botulinum toxin (BOTOX) causes temporary paralysis of the finger extensor tendons.

But that’s how BOTOX works – it is a paralyzing agent designed to give the tendons/muscles a rest. This effect is gone two to three months later. Hopefully that is enough rest for those overused tendons that have experienced microtearing and progressive degeneration of the common extensor tendon at the elbow.