Stem Cell Therapy for Elbow Tendonitis including Golfers Elbow and Tennis Elbow
Elbow tendinitis is caused by damage to the elbow tendons, and is classified as tennis elbow or golfer’s elbow, depending on the site of tenderness. Tendons are tissues that connect muscle to bone. People who perform repetitive gripping activities are susceptible to this condition. Repetitive motions, such as striking a tennis ball with a racket, typing, or carpentry, can cause excess stress on tendons, leading to micro tears.
Tennis elbow is caused by pain and swelling in the tendons responsible for holding the muscles of the lower arm (lateral side) to the bone. Tennis elbow is associated with tenderness at the bony knob on the outside elbow. The pain may radiate to the upper and lower arms. The pain sensation is mostly felt while performing tasks, such as lifting objects, opening a door, shaking hands, etc. Tennis elbow is alternatively known as lateral epicondylitis.
Another condition, golfer’s elbow, is caused by painful swelling of the tendons located on the inside of the elbow (the medial side). Golfer’s elbow is alternatively known as medial epicondylitis.
TENDINITIS VS. TENDINOSIS
It is to be recognized that tendinitis is different from tendinosis. While the former increases blood flow to the affected area and helps in healing through protective pain and inflammatory factors, the latter goes unrecognized in the body and progressively leads to further deterioration.
Diagnosis of elbow tendinitis is through physical examination to determine the exact location of the tenderness. Imaging tests, such as X-ray and Magnetic resonance imaging (MRI), is performed to negate the possibility of other underlying problems.
Elbow tendinitis seems to heal by itself with rest, cold application to the tender area, or by using an elbow strap. In fact, rest of the wrist joint is thought be the best treatment for tennis and golfer’s elbow. When the wrist joint is rested, the forearm muscles along with the elbow tendons can rest and recuperate.
Nonsteroidal anti-inflammatory agents, such as ibuprofen, naproxen, may be used to alleviate swelling and pain.
Individuals may also practice various physical therapy exercises to increase range of motion and improve muscle strength. For example, stretching exercises for the forearm muscles help to bring back proper tone to hypertonic muscles, thereby helping to prevent elbow tendinitis. Active Release Technique (ART) is a massage technique that may also be beneficial for the relief of these conditions.
In addition, steroid injections at the site may help improve swelling and pain. However, the effect of steroid injections is not long lived, and these medications are associated with unpleasant side effects.
If non-invasive therapies do not work in individuals, surgery may be necessary to relieve tennis elbow symptoms. For example, a pain lasting longer than 3 months may be better controlled with surgery. Surgery is done to remove the damaged part of the tendon and repair the remaining portion. The success of the surgery is 85 – 90 %. Almost 50% of patients with tennis elbow require surgery for their symptoms.
Patients who do not respond to conservative treatment, may try platelet-rich plasma (PRP) injections to stimulate repair of the damaged tendon. Platelet-rich plasma is derived from the patient’s blood sample. It is known that platelets secrete growth factors that are essential for tissue repair. PRP therapy has the potential to provide lasting pain relief of musculoskeletal conditions, such as elbow tendinitis, through tissue healing.
Stem cells are primitive cells that can undergo differentiation to form different types of cells in the body, such as bone, blood, cartilage, etc. These cells are responsible for healing tissue damages by generating new healthy cells. However, with age, the body loses its ability to attract enough stem cells to the site of injury. In this regard, stem cell therapydelivers a high concentration of stem cells to the affected area to promote natural healing.
A past study has demonstrated the usefulness of surgery followed by stem cell injection for treating stubborn cases of tennis elbow. Stem cells derived from the bone marrow were used in this study. This innovative therapy led to an early return to daily activities following surgery. Moreover, evidence of tendon repair was observable through ultrasonographic techniques.
The most revolutionary regenerative medicine treatments now being offered include amniotic and umbilical stem cell treatments. These are FDA regulated and contain growth factors, hyaluronic acid, cytokines and stem cells.