55 year old patient presented with a 2 year history of left elbow pain which was constant in duration, 8/10 in severity, progressive in nature, localized on the lateral (outside) aspect of elbow without any radiations. Patient drives a city bus and sustained a slip and fall injury in which he struck his left elbow. He denied any neck or arm pain. Treatment to date had included massage, x-rays, cortisone injections into the joint and oral narcotics. Narcotics were started “since other therapies had failed”. Patient had a known addictive personality and was a recovering alcoholic. He was using up to 8 Vicodin /day as prescribed.
On physical examination he had extreme tenderness over the outside aspect of the elbow (lateral epicondyle) and multiple tender points along the extensor muscles in his forearm. His neurologic exam was normal.
Lateral epicondylitis is theorized to be an injury of repetitive microtrauma/overuse.
It is commonly caused by commonly associated with playing tennis and other racquet sports.
It can also be caused by sustained contraction of the extensor muscles in the forearm which result in excessive force on the tendon where it is attached on the bone. Treatment is two-fold: relax the dysfunctional muscle and promote healing. This is possible by IMS and prolotherapy.
Following regenerative therapy at the Centeno-Schultz Clinic, patient had reduction in his pain, increase in range of motion and elimination of all narcotics.