Written by Kathleen Papi-Baker, OTR, CHT and Jessica Karge, OTR, CHT
First of all, you may wonder what kind of doctor you should see? Since tennis elbow is a fairly common condition, your family practice physician should be able to make the diagnosis. They will do a little poking and prodding to rule out a joint or nerve problem, and rule in tennis elbow. They will do some provocative testing, such as asking you to hold your wrist straight, while the doctor tries to flex your wrist. This typically produces pain at the outside of the elbow when you have tennis elbow.
Once the diagnosis is made, a variety of options may be presented to you. The following list is a options your doctor may suggest.
*Physical or hand therapy may be suggested if your symptoms are not chronic. You will learn about tennis elbow, and be taught specific stretches, and exercises. Of course Treat Yourself Therapy's Tennis Elbow video is an option here!
*Cortisone injection around the affected tendon. Cortisone is an anti-inflammatory hormone that relieves pain in the short run, typically yielding relief up to 4 – 6 weeks.
*Dry needling, or percutaneous needle tenotomy, which involves poking the tendon/bone unit with a needle to create an irritation, which creates an environment for healing to occur. This can be done in combination with a cortisone injection.
*Prolotherapy is similar to dry needling, however, in addition an irritant is injected into the tendon to create an inflammatory reaction, with the goal of stimulating a healing response.
The next two options are called biologics. These procedures, as explained by Dr. Joseph Albano, a musculoskeletal specialist in Salt Lake City, involve using the body's own tissues to aid in the healing process, and are appropriate for more chronic conditions. Dr. Albano first uses diagnostic musculoskeletal ultrasound to identify the extent of the damaged tissue. This ultrasound shows more detail in lateral epicondylitis than an MRI, being able to detect the thickening of the tendon, and they are less expensive. It is a dynamic diagnostic tool in that it can show the tendons and muscles while they are moving.
*Platelet Rich Plasma, referred to as PRP, is a procedure that involves spinning the patient's own drawn blood to obtain a higher concentration of platelets. These platelets contain tendon healing growth factors. Using ultrasound as a guide, the platelets are injected into the damaged area to facilitate healing.
*Augologous blood injections involve the patient's drawn blood being injected back into the damaged area without platelet separation.
*Focus aspiration of scar tissue, or FAST, is a procedure that uses ultrasonic energy to break up and remove damaged tissue after the tissue is first identified with diagnostic musculoskeletal ultrasound.
Surgery for lateral epicondylitis may be an option for some who do not respond to conservative treatment, and/or may show a tendon tear after diagnostic testing. In this surgery, the damaged part of the tendon is removed.
There are a lot of options available today for people with tennis elbow. Be an informed consumer, and be familiar with what is available before you make any decision regarding your care. Be sure to see a physician experienced in the procedures you are considering.
Once the diagnosis is made, a variety of options may be presented to you. The following list is a options your doctor may suggest.
*Physical or hand therapy may be suggested if your symptoms are not chronic. You will learn about tennis elbow, and be taught specific stretches, and exercises. Of course Treat Yourself Therapy's Tennis Elbow video is an option here!
*Cortisone injection around the affected tendon. Cortisone is an anti-inflammatory hormone that relieves pain in the short run, typically yielding relief up to 4 – 6 weeks.
*Dry needling, or percutaneous needle tenotomy, which involves poking the tendon/bone unit with a needle to create an irritation, which creates an environment for healing to occur. This can be done in combination with a cortisone injection.
*Prolotherapy is similar to dry needling, however, in addition an irritant is injected into the tendon to create an inflammatory reaction, with the goal of stimulating a healing response.
The next two options are called biologics. These procedures, as explained by Dr. Joseph Albano, a musculoskeletal specialist in Salt Lake City, involve using the body's own tissues to aid in the healing process, and are appropriate for more chronic conditions. Dr. Albano first uses diagnostic musculoskeletal ultrasound to identify the extent of the damaged tissue. This ultrasound shows more detail in lateral epicondylitis than an MRI, being able to detect the thickening of the tendon, and they are less expensive. It is a dynamic diagnostic tool in that it can show the tendons and muscles while they are moving.
*Platelet Rich Plasma, referred to as PRP, is a procedure that involves spinning the patient's own drawn blood to obtain a higher concentration of platelets. These platelets contain tendon healing growth factors. Using ultrasound as a guide, the platelets are injected into the damaged area to facilitate healing.
*Augologous blood injections involve the patient's drawn blood being injected back into the damaged area without platelet separation.
*Focus aspiration of scar tissue, or FAST, is a procedure that uses ultrasonic energy to break up and remove damaged tissue after the tissue is first identified with diagnostic musculoskeletal ultrasound.
Surgery for lateral epicondylitis may be an option for some who do not respond to conservative treatment, and/or may show a tendon tear after diagnostic testing. In this surgery, the damaged part of the tendon is removed.
There are a lot of options available today for people with tennis elbow. Be an informed consumer, and be familiar with what is available before you make any decision regarding your care. Be sure to see a physician experienced in the procedures you are considering.
