Approximately 80% of patients will improve over 1-3 years, with the disease process being self-limiting in the majority of patients.8 In the acute phase exacerbating factors should be removed. Topical non-steroidal anti-inflammatories (NSAIDs) and ice may also be effective.
Physiotherapy and Orthoses
As for tennis elbow, patients must remove the exacerbating factors that overload the tendon. A programme of eccentric exercises and graduated loading can be effective along with clasps that aim to offload the tendon. A home exercise program of eccentric exercise improved both pain and grip strength at 3 months.9
Allows short-term relief but does not appear to affect the disease process in the long term.10 Complications include skin and sub-cutaneous fat atrophy at the injection site and patients need to be warned of this.
Platelet Rich Plasma / Autologous Blood Injections
Most of the research in this field has been carried out on tennis elbow. It has been shown in a study of 20 patients that neovascularisation and pain scores are improved at 10 months after dry needling and autologous blood injections.11 Good quality research is needed to prove this treatment modality is effective.