Tennis Elbow (Lateral Epicondylitis)

Tennis elbow, the clinical term for which is lateral epicondylitis, is a degenerative condition of the common extensor tendon at its attachment to the lateral epicondyle of the humerus. The name is misleading. Most patients who develop it have never picked up a tennis racquet. Carpenters, plumbers, electricians, and anyone whose work involves repetitive gripping, lifting, and wrist extension are the more common presentation in the western Palm Beach County community.

The condition develops through repeated micro-tearing at the tendon insertion that outpaces the body's capacity to repair it. The result is a degenerative tendinosis, not an acute inflammatory tendinitis. The distinction matters because it explains why rest and anti-inflammatories provide incomplete relief. The tissue is not simply inflamed. It is structurally compromised at a level that requires biological repair signals to resolve.

What Makes Lateral Epicondylitis Persistent

The extensor carpi radialis brevis is the primary structure involved in most cases. It bears the greatest mechanical load during gripping and wrist extension and has relatively poor blood supply at the humeral insertion, which is why degenerative changes accumulate there rather than resolving. A construction worker gripping tools on Okeechobee Blvd job sites five days a week has no opportunity for the repetitive stress to abate long enough for spontaneous recovery. The tissue continues to degrade.

Nerve involvement complicates a meaningful percentage of lateral elbow pain presentations. The posterior interosseous nerve passes through the arcade of Frohse near the lateral epicondyle and can be compressed as it does. A patient with cervical root irritation at C6 or C7 can present with lateral elbow pain that closely mimics tennis elbow. Dr. Dean Mammales, DC evaluates the cervical spine and radial nerve pathway at the initial visit to rule out referred pain before focusing treatment on the elbow itself.

MLS Laser Therapy

MLS laser therapy delivers therapeutic wavelengths directly into the tendon insertion at the lateral epicondyle. The 808 nm wavelength reduces local inflammation and edema. The 905 nm pulsed wavelength stimulates cellular repair activity in the tendon tissue. For acute to subacute cases, 6 to 8 sessions is typically sufficient. For chronic presentations where the patient has had symptoms for more than six months, a longer protocol combined with instrument-assisted soft tissue mobilization produces better outcomes.

PRP for Chronic Tennis Elbow

For patients with persistent lateral epicondylitis unresponsive to conservative care, PRP injection is the most evidence-supported non-surgical intervention available. A 2021 systematic review in the American Journal of Sports Medicine found PRP superior to corticosteroid at 12 weeks and beyond. Yuleisy Coto, MSN, APRN, FNP-C administers PRP injections at Cobblestone. The concentrated platelet fraction is injected directly into the degenerative tendon under precise technique, initiating the repair cascade that chronic overuse has prevented. Results develop over four to ten weeks.

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