Elbow pain is nearly always a tendon problem — tennis elbow on the outside, golfer’s elbow on the inside — and nearly always treatable without surgery. Ultrasound shows the degree of tendon damage and guides the injection; PRP has the best evidence for lasting recovery.
The forearm muscles attach to the elbow through short, poorly supplied tendons that degenerate under repetitive load rather than inflame — which is why anti-inflammatories give limited relief. The ulnar nerve runs in a shallow groove on the inner elbow and is easily compressed.
Examination of grip, resisted movements and nerve function; ultrasound to grade tendon change, look for tears and calcification, and check the nerve. X-ray if arthritis or loose fragments are suspected.
Conditions treated
Degeneration of the extensor tendons on the outer elbow. Pain on gripping and lifting. First-line: a loading programme and a counterforce brace. For persistent pain, an ultrasound-guided PRP injection has the strongest evidence for durable improvement; steroid gives faster but shorter relief with higher recurrence and is used sparingly.
The same process in the flexor tendons on the inner elbow. Treated the same way — loading, then ultrasound-guided PRP for persistent cases. The ulnar nerve is checked, since it sits next to the tendon.
A fluid swelling at the point of the elbow after pressure or a knock. Aspiration under ultrasound, with a steroid injection if not infected. Infected bursitis needs antibiotics, not injection.
Compression of the ulnar nerve at the elbow: tingling in the ring and little fingers, weak grip. Ultrasound-guided hydrodissection — freeing the nerve with fluid — for mild to moderate cases; surgical release when there is muscle wasting.
Wear of the joint after injury or heavy use; stiffness and pain at the ends of movement. Ultrasound-guided joint injection for flares.
Fifteen to thirty minutes. PRP begins with a blood draw and takes about forty-five minutes overall. Expect soreness for a few days after a tendon injection; normal light use resumes within a week.
Tendons recover through controlled loading, not rest. Complete rest weakens them further.
Steroid: quick relief, wears off, higher recurrence. PRP: slower onset over four to eight weeks, longer-lasting improvement. For tennis elbow, PRP is preferred.
Usually one or two, six weeks apart, reviewed on response.
Yes, with modified load for the first fortnight after injection.
Rarely — for tears that do not respond after several months, or nerve compression with wasting.