Acute and chronic forearm pain is a very common condition in musicians and particularly drummers requiring them to seek medical care. The repetitive wrist and elbow motion required to play drums predispose us to developing forearm muscle tendon overuse injuries.
Tennis elbow or lateral epicondylitis, the most common of these entities encompasses a variety of disorders involving the muscle and tendons that lift or extend you wrist. It had been felt that these injuries were due to an inflammatory response in the tendons themselves. However, it is now believed to be due to a degeneration of the tendon tissue (tendinosis). Tendinosis most commonly develops in our 40s or 50s, but can occur at much younger ages.
Typically, treatment is conservative in nature, relying on oral anti-inflammatory medication, ice application, physical therapy, relative rest from the activity believed to have caused the injury, exercise, stretching and corticosteroid injections. For more chronic painful conditions that did not respond to conservative care, surgical repair of the tendon would be considered.
Recently, an alternative treatment for chronic tendinosis has been developed that may give the same or better results than surgical treatment, with a single simple injection of the patient’s own blood.
Dr. Allan Mishra and orthopaedic surgeon at Stanford University are leading the research of utilizing Buffered Platelet-Rich Plasma injections for the treatment of chronic painful tendosis. Plasma is the liquid portion of the blood comprising of 90% water and the platelets or thrombocytes are the irregularly shaped bodies in the blood responsible for blood clotting. Within platelets are powerful growth factors that are believed to promote the healing process when injected in concentrated form by acting on the cellular components of the tendon.
The process is straightforward and simple. A small amount of blood is drawn from the patient, and then spun at a very high speed in a special cartridge for 15 minutes. The layered blood containing the Platelet-Rich Plasma component is removed and injected into the injured tendon.
Preliminary results have shown that Platelet-Rich Plasma injections had success rates similar to those treated surgically for chronic tennis elbow, with less pain and allowing them to resume normal activities after a single injection.
Further research will help determine whether this exciting new treatment will give lasting relief for this chronic and common problem.