PRP Injections for Elbow

The elbow joint is made up of three bones- the humerus (upper arm bone) and the two bones in the forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside of the elbow (lateral side) is called the lateral epicondyle and the bony bump on the inside of the elbow (medial side) is called the medial epicondyle. Elbow anatomy also includes a complex system of ligaments, tendons and muscles that hold the joint together and provide stability and joint function.

Medial epicondylitis, more commonly known as golfer’s elbow, involves damage to the wrist flexors on the inner portion of the elbow. Wrist flexors are the muscles in the palm side of the forearm that pulls the wrist down. Most of the wrist flexor tendons attach to the medial epicondyle. As the wrists flex and form a grip, the forearm muscles tighten and pull on the tendons. During a golf swing, force is put on the flexor muscles and the tendons attaching these muscles to the medial epicondyle in the elbow. When the wrist flexor tendons are weakened due to overuse, microscopic tendon tears occur where the tendon attaches to the medial epicondyle. These microscopic tears lead to inflammation and pain, which causes golfer’s elbow.

Tennis elbow is similar to golfer’s elbow, but it occurs on the outside rather than the inside of the elbow joint. Lateral epicondylitis, more commonly known as tennis elbow, involves damage to the muscles and tendons on the outer portion of the forearm. The forearm muscles extend the wrist and fingers, which is repetitively used in the groundstroke of tennis. The main tendon associated with tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB), which attaches to the lateral epicondyle. The position of the ECRB is at risk due to the position – as the elbow bends and straightens the muscles rub against the epicondyles. When the ECRB is weakened from overuse, microscopic tendon tears occur where the tendon attaches to the lateral epicondyle. These microscopic tears lead to inflammation and pain, which causes tennis elbow.What are Blood PRP Injections?

Platelet rich plasma injections, sometimes referred to as blood PRP injections, are a non-surgical treatment option for chronic tendon injuries and acute ligament and muscle injuries. Blood PRP injections combine modern technology with the body’s natural healing abilities for accelerated healing after an injury.

Platelets, one of the four main components of human blood besides plasma, white blood cells and red blood cells, initiate tissue repair by releasing growth factors. These growth factors are a naturally occurring substance capable of stimulating cellular growth and accelerating healing of soft tissue injuries in the elbow.

PRP injections can be a valuable treatment option prior to surgery when more conventional treatment options have failed.

Dr. Waterman begins PRP injections for the elbow by removing a small vial of blood, typically 30 milliliters, from the patient’s arm. The blood is then spun in a centrifuge, a machine that uses high speeds to separate the four main blood components. Once the components are separated, the platelet rich plasma is removed. The plasma is then injected into the elbow at the site of pain to allow the growth factors to gravitate towards the injured soft tissue. Since blood PRP is extracted from a patient’s own blood, the risk of reaction is very low.

PRP injections for the elbow are a relatively quick procedure taking less than 15 minutes. Response to treatment varies with each patient, depending on soft tissue injury severity. Most patients will require 1-3 sets of PRP injections, with each set of treatments spaced 4-6 weeks apart.