Golfer’s elbow and tennis elbow are two of the most common injuries I work with on the physical side of my naturopathic practice. They are often “nagging injuries” in the sense that they can persist for many months or possibly years if they are not treated properly. They are also very fickle injuries because they can become re-aggravated for reasons that don’t seem to make sense. For example, many people will be able to do heavy lifting without pain but can’t drink a cup of coffee without a flare of pain. In this article, we will investigate the use of Prolotherapy for the treatment of golfer’s elbow and tennis elbow.
The elbow is a complex joint that is held together by ligaments. In most cases, the ligaments holding the elbow together are not the driving factor behind the chronic pain and symptoms. Most people who suffer from golfer’s/tennis elbow will have strong ligaments but will instead have damage to the tendons. The majority of the muscles that allow your hand and fingers to extend backwards have their origin at the outside part of the elbow. This attachment point is called the lateral epicondyle. The majority of the muscles that allow your hand and fingers to flex forward have their origin at the inner part of the elbow, called the medial epicondyle. It is at these attachment points where the tendons start to tear and cause the symptoms of tennis elbow (lateral epicondylitis) or golfer’s elbow (medial epicondylitis).
Prolotherapy is the technique I use for the treatment of tennis elbow and golfer’s elbow. The job of prolotherapy is to regenerate and re-grow damaged ligaments and tendons by stimulating the patient’s immune system. It all starts with identifying precisely where the damaged tissue is. Once this is identified, a dextrose/sugar solution is injected into the damaged tendon. The purpose of the injection is two-fold. First of all, the needle causes further damage to the tendon. This new injury is needed in order to properly stimulate healing. The second purpose of the injection is to perfuse the area in a sugar solution, which further promotes the immune system to heal the damaged tissue.
It typically takes 3-6 Prolotherapy treatments for optimal re-growth of the damaged tissue that causes tennis elbow or golfer’s elbow. Two to four weeks is taken between sessions to allow for the proper healing cycle to be carried out. Prolotherapy is a relatively non-invasive procedure done during office visits. While the injections are moderately painful during the treatment, there is typically no new pain between sessions. Most people will be stiff for 1-2 days after Prolotherapy and then start to feel improvement as the tissue begins healing.
During the healing time between sessions it’s usually best to prevent re-injury by avoiding harmful activities, wearing a brace during questionable activities, and seeing another practitioner like a chiropractor, massage therapist, or physiotherapist who can support muscle function.
