Inflammation of the tendon (tendonitis) is the most common cause of golfers and tennis elbow (pain on inside of elbow and outside of the elbow, respectively). The reason why golfers and tennis elbow occur is due to repetitive movements where the tendons around the elbow persistently rub over the bony aspects of the joint. This occurs when performing activities such as swinging a golf club or tennis racquet, or when performing normal activities such as shaking hands, opening a door, or lifting up objects.
Signs and symptoms of elbow tendonitis
Elbow tendonitis can be an extremely painful condition that can cause disability in patients to the point where they cannot perform their normal daily activities.
Affected individuals will complain of severe pain over the inside or outside aspects of the elbow, depending on which tendons are affected, and this can be associated with tenderness and swelling of the joint. There may also be limited mobility of the elbow with a decreased range of motion. Pain in the joint may also refer up and/or down the arm, with pain being experienced in the shoulder and/or wrist joints, respectively.
Management of elbow tendonitis
Elbow tendonitis can heal by itself with supportive measures such as resting the limb of the affected joint, applying cold compresses to the tender area, and by using an elbow support or strap. Resting the wrist joint is actually part of the protocol of golfer’s and tennis elbow treatments because when this joint is rested, the muscle and tendons in the forearm rest and can recover over a shorter period of time. Anti-inflammatory medications are used to help offer pain relief by reducing the inflammatory response in the tendons of the affected elbow.
If these conservative golfer and tennis elbow treatments are not effective, then physical therapy and even surgery may be indicated. Before surgery is warranted though, innovative therapies can be initiated.
Platelet-rich plasma and stem cell therapy
Platelet-rich plasma (PRP), derived from the patient’s own blood, is a safe and effective therapy in the treatment of elbow tendonitis. The PRP is administered to the patient via an injection and this promotes tissue repair in the damaged tendon. This process involves the platelet cells stimulating the release of growth factor and stem cells from the body which is essential for tissue repair and natural healing.
Stem cells derived from the bone marrow were used in a previous study that demonstrated the usefulness of surgery followed by stem cell administration for managing severe and persistent cases of tennis elbow. The outcomes of the patients who were administered stem cells were an early return to daily activities following surgery, and a reduction in complications on their follow-up visits. Tendon repair was evident when the tissue was observed through ultrasound techniques.
Stem cells have also been derived from adipose (fat) tissue. These cells take longer to be harvested from adipose tissue, but they can be stored and used at a later stage. The stem cells collected from fat are, like PRPs, derived from the patient and does not involve the harvesting cells from embryos.