PRP Injection vs Physical Therapy for Tennis Elbow Pain

Summary of the video

Tennis elbow pain often lasts for months or even years. Many people try physical therapy but still experience symptoms returning. The video discusses a randomized controlled trial (over 200 patients followed for 2 years) comparing multiple treatments:

• Physical therapy: daily stretching and eccentric wrist strengthening
• PRP (platelet-rich plasma) injection: a single ultrasound-guided injection of concentrated platelets into the diseased tendon
• Prolotherapy: dextrose injections intended to trigger a healing response
• Extracorporeal shockwave therapy: mechanical energy pulses delivered to the tendon

By 24 months, all treatment groups improved, but PRP and prolotherapy performed best. PRP showed the largest advantage over physical therapy, including:

• DASH score improvement: about 31 points for PRP vs 19 points for physical therapy
  • A 10-point change is clinically meaningful
• Patient satisfaction: higher with PRP (4.6/5) vs physical therapy (3/5)
• Shockwave therapy: did not outperform exercise/physical therapy

Why PRP may work better

The video explains that PRP may help by delivering concentrated growth factors directly into the damaged tendon. The goal is to signal the tendon to:

• produce new collagen
• restore blood supply
• remodel chronically degenerative tissue

This approach aims to repair the tendon itself, rather than only training muscles around it.

Clinical takeaway

The speaker recommends starting with a structured exercise program for 4–6 weeks, since many people improve with consistent rehabilitation. If symptoms persist or are severe, PRP is presented as a logical next step—a more aggressive option intended to address the underlying tendon-healing failure.

Speakers (identified)

• Dr. Jeff Ping