🔍 What Causes Tennis Elbow?

Tennis elbow is not just inflammation—it’s often a degenerative process involving microtears and collagen disorganization in the extensor carpi radialis brevis (ECRB) tendon.

Common contributing factors include:

– Repetitive motions like gripping, lifting, or using a mouse

– Manual labour (e.g., carpenters, plumbers)

– Playing racquet sports with poor technique

– Age-related degeneration (most common in adults aged 30–50)

⚠️ Recognizing the Symptoms

People with tennis elbow typically report:

– Pain or burning on the outer part of the elbow

– Weakened grip strength

– Pain that worsens with activity (e.g., lifting a kettle or shaking hands)

– Occasionally, radiation of pain down the forearm

🛠️ Traditional Treatment Approaches

Treatment usually begins conservatively. Here’s a look at the most common approaches:

1. Rest and Activity Modification: Reducing or avoiding aggravating activities is essential. Though absolute rest isn’t usually necessary, relative rest allows the tendon time to recover.

2. Splinting and Bracing: Counterforce braces or wrist splints can reduce strain on the extensor tendon during activity. However, long-term use isn’t encouraged due to risk of weakening surrounding muscles.

3. Ice Therapy: Applying cold packs can help with pain relief, particularly in acute flare-ups.

4. Physiotherapy and Eccentric Exercises: Rehabilitation with eccentric loading exercises (like the Tyler twist) can stimulate tendon healing by promoting collagen realignment.

5. Corticosteroid Injections: Steroid injections may offer short-term pain relief, but studies show they may be harmful to tendon health in the long run, potentially delaying healing or contributing to tendon degeneration or rupture.

🧪 The Emerging Role of Platelet-Rich Plasma (PRP)

One of the most exciting frontiers in musculoskeletal medicine is the use of platelet-rich plasma (PRP)—a treatment that taps into the body’s own healing capabilities.

💡 What Is PRP?

PRP involves drawing a small amount of the patient’s blood, spinning it in a centrifuge to concentrate the platelets, and then injecting that platelet-rich fraction directly into the degenerated tendon.

Platelets release growth factors such as PDGF, TGF-β, and VEGF, which:

– Stimulate angiogenesis (new blood vessel formation)

– Promote collagen production

– Reduce inflammation

– Encourage tissue healing

📊 What Does the Evidence Say?

Clinical trials and meta-analyses have increasingly supported PRP’s role in treating lateral epicondylitis:

– A 2014 randomized trial by Mishra et al. found PRP to be superior to corticosteroids at 24 weeks in reducing pain and improving function.

– A 2019 meta-analysis by Arirachakaran et al. (Arthroscopy) showed that PRP offered longer-lasting pain relief and better functional outcomes than corticosteroid injections or autologous blood.

💬 A Word of Caution: Not All PRP Is Equal

There are different types of PRP (leucocyte-rich vs. leucocyte-poor), and preparation methods vary widely. The efficacy of PRP depends on:

– Platelet concentration

– White blood cell content

– Activation method

– Injection technique (ultrasound-guided vs. blind)

It’s crucial to seek treatment from providers experienced in standardized, image-guided PRP protocols to ensure the best outcomes.

✅ Conclusion: Why PRP May Be the Best Option

Tennis elbow is a common, often stubborn condition. While rest, braces, and rehab help many, steroid injections may offer only fleeting relief and risk tendon harm. PRP, on the other hand, promotes genuine healing and has shown excellent results in both scientific litreature and clinical practise.

As our understanding of tendon biology advances, regenerative therapies like PRP represent a paradigm shift—from just manageing symptoms to healing the underlying problem.