Pain in the elbow area is most often due to tendinopathy of the wrist extensor and flexor muscles (tennis or golfer’s elbow), with pain and tenderness on the outer and inner surface of the elbow and pain on flexion and extension of the wrist under resistance.Constant stress and microtrauma play a causative role.

If relative rest, medication, and physiotherapy do not work, the application of local injections is the next step.

Injections of local anesthetic with or without steroid agents, prolotherapy, and PRP (platelet-rich plasma) are applied in our clinic using ultrasound that helps both in the diagnosis and in the correct application of the injections, as well as in the performance of percutaneous tenotomy (instead of open surgery). The latter is applied to chronic (> 6 months) tendinopathies, with studies reporting positive results in reducing pain.

Osteoarthritis of the elbow joints with tenderness, painful movement, ultrasound findings of fluid collection and/or radiological abnormalities, is treated with similar injections as well as cases of ligamentous injury, which should be examined, especially in cases of failed repeated steroid injections (in patients with tennis elbow). The latters should be avoided due to the possibility of weakening of the tendons, ligaments and hyaline. For the same reason, the dosage of steroids, when used, should be as low as possible.