Tennis Elbow Treatment – PRP Injections
PRP (PLATELET-RICH PLASMA) Treatment For Tennis Elbow (Lateral Epicondlyitis)
By: Dr. Bruce Steinberg, Jacksonville Orthopaedic Institute
Commonly Asked Question
Since PRP (platelet-rich plasma) is not covered by insurance, is it worth the out-of-pocket cash expense?
Tennis Elbow
Tennis elbow is a very common condition which causes pain along the outside portion of the elbow. Gripping, should be torquing, pinching and lifting of even light objects such as a coffee cup can become exquisitely painful. The lay press has reported on a treatment that has been used for tendinopathies including tennis elbow, PRP (platelet-rich plasma). PRP is a technique in which blood is drawn from the patient and spun down extracting the serum portion of the blood that includes the platelets. The theory is that this portion of the blood, when injected back into the area of the injured, inflamed tendon, will lead to its healing. The question is whether or not this particular treatment is any better than the standard treatment of corticosteroid injection . The theory certainly seems to make sense.
Does PRP Work?
There are many types of reports in medicine when it comes to a treatment and evaluation of a procedure. The best peer review scientific reports have not yet proven that PRP works any better than the accepted treatment of corticosteroid injection. The studies which doctors most rely upon are those that are performed for a group of patients with the same condition, where both the doctor and the patient are “blinded” to the treatment. A “blinded” study means that the doctor and the patient do not know if they are receiving the old treatment of corticosteroids versus a new treatment of PRP. Finally, these studies re-evaluate the patients over time to see if one treatment was better than the other.
Research Study
The largest most recent studies to look at this question have not found that one treatment is better than another. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: a randomized, double-blind, placebo-controlled trial;
Effects of platelet-rich plasma on lateral epicondylitis of the elbow: prospective randomized controlled trial; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767828/
In fact, in one large “systemic” review of the entire literature demonstrated strong statistical evidence against platelet-rich plasma injections. Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy.
PRP for Tennis Elbow
Tennis elbow can be a very frustrating painful condition. Patients are even willing to pay for treatments such as PRP, which are not covered by insurance, with out-of-pocket funds. It is the job of the physician to review the scientific literature and make recommendations to the patient based on the best studies available. While one can certainly seek to undergo PRP treatment, to date there is no evidence that this treatment is better than the standard treatment. If further evidence becomes available that should change this opinion, then PRP would become one of the initial treatment options most likely also covered by insurance.
The literature overwhelmingly demonstrates that corticosteroid injection has an 80-95% success rate curing the condition of tennis elbow (lateral epicondylitis). This treatment with activity modification and specific stretching and strengthening exercises usually resolves the problem. Surgical intervention in a small group of patients for failed conservative treatment has a greater than 90% success rate. Surgical treatment for lateral epicondylitis: a long-term follow-up of results
If you are interested in the treatment of tennis elbow (lateral epicondylitis), please contact Jacksonville Orthopaedic Institute at (904) JOI-2000 or schedule online.
Related Article: How to get rid of tennis elbow.
JOI and JOI Rehab
JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.
You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference.
To make appointments with JOI Rehab, please call 904-858-7045.