Elbow Tendinitis Pain
Pain at the outside (lateral) or inside (medial) elbow that seems to appear relatively suddenly and remain persistently is generally the classic onset of tennis elbow (outside elbow) or golfer's elbow (inside elbow). To dispel some of the myths associated with this condition, most cases of tennis elbow (lateral epicondylitis) are not the result of playing tennis and most cases of golfer's elbow (medial epicondylitis) are not the result of playing golf. These conditions, however, do always result from repetitive activities, do not favor the dominant arm side, and do not favor either males or females.Elbow tendinitis is better named elbow tendinosis because it is normally not very inflammatory. Thus, anti-inflammatories usually help very little. The condition results from repetitive traumatic microtearing of the tendon where it attaches to the bone. It is the kind of thing that builds up over time without you knowing it. The type of repetitive trauma is often times difficult to identify because, in many cases, the elbow has been working at the incorrect angle because of shoulder misalignment. In this case the elbow suffers from what would otherwise be normal daily activities. Because of shoulder deviation the elbow is not working in its' normal line of force in reaching, lifting, or gripping. Instead of the normal elbow work and strain being shared equally by the medial (flexors) and lateral (extensors) the work is transferred excessively toward one side or the other. Thus, the painless (or mildly painful) but faulty shoulder is often the cause of elbow tendinitis and this fault must be corrected if the elbow is to recover.
In addition to elbow and shoulder corrective therapies and exercises, the resistant elbow tendinitis may also require Prolotherapy in order to promote the regrowth of connective tissue to replace the micro-torn connective tissue at the elbow-tendon interface where the pain predominates. If a brief course of elbow tendinitis treatment is not producing the desired results the PINS Prolotherapy can then be undertaken. A recent NIH (National Institutes of Health) government-sponsored study on the effectiveness of Prolotherapy for tennis elbow concluded that Prolotherapy "effectively decreased elbow pain and improved strength" compared to the control subjects (available in PMC 2009, Sept 24).
The reason elbow tendonosis is so persistent is that, rather than inflammatory, it is termed angiofibrotic- that means that this problem area has a tendency to lack good blood flow. This is the basis for considering Prolotherapy essential for the stubborn elbow tendonosis- because it brings new blood to the area. At Combined Care Center we do many cases of tennis elbow each year and usually we will need to perform PINS Prolotherapy in order to speed the recovery process.
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