Elbow pain improperly diagnosed as tendonitis -
true diagnosis is TENDINOSIS

MR, a 46 year-old factory owner, came to Caring Medical with elbow pain that was causing him to be unable to perform his daily activities. The pain had been present for six weeks and originated when he was working with a saw. He had sharp pain that interfered with most of his daily activities, specifically movements that involved a twisting motion such as opening a door and working out with dumbbells. The only relief he had from pain was when he completely immobilized his arm. When he went to see his doctor he was diagnosed with tennis elbow and given a cortisone shot. After no response from the cortisone shot, he decided to come to Caring Medical for treatment. MR was familiar with Prolotherapy after it healed his knee injury two years prior.

Dr. Hauser examined MR’s elbow and noted tenderness in various structure points. Although MR brought an X-ray, it offered no indication of the cause of MR’s pain. This is something we see often with X-ray imaging, because ligaments and tendons do not show up on X-ray. The physical examination, however, showed that MR had tendinosis, or a degenerated tendon, of the elbow. This injury was most likely caused by overuse during work and exacerbated by the cortisone shot. Cortisone degenerates the muscle origin or insertion. The proper treatment for tendinosis is Prolotherapy, which stimulates the body to repair tendon insertions and origins by inducing the proliferation of cells called fibroblasts to lay down collagen. Collagen is the tissue that makes up tendons and muscles. Therefore instead of one cortisone shot that inhibited healing, MR would need multiple Prolotherapy injections to induce healing.

MR’s treatment consisted of 18 injections of a standard Prolotherapy solution to various structural points of his elbow. With the Prolotherapy technique used by Dr. Hauser, the Hackett Hemwall technique, the whole area is treated, not just a couple of injections. In MR’s case, his treatment also included two injections of  platelet rich plasma  (PRP) solution. These injections consisted of the platelet-rich portion of MR’s blood that was drawn from his arm, centrifuged, and injected back into MR’s elbow. Dr. Hauser estimated that MR would need two to five treatments to his elbow at 2-4 week intervals to achieve complete healing. He instructed MR to use his opposite arm as much as possible and to begin swimming to attain gentle range of motion exercises.

MR returned two weeks later for his second Prolotherapy treatment. He noted a decrease in pain with a dull pain sensation triggered with use of his affected elbow. Dr. Hauser performed the same treatment, 18 injections with a standard Prolotherapy solution and two injections with PRP.

Over a year later MR is pain free and very happy with the results of his two Prolotherapy treatments. He is able to use his elbow with no pain and is able to exercise for twice as long as he had prior to Prolotherapy. He said that Prolotherapy with PRP met his expectations and he was grateful for the speedy recovery.