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Injuries and Medical Advice

Quack Elbow Treatments to Avoid

Platelet Rich Injections for Elbow Pain?

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Acute trauma can lift a chunk out of the synovial cartilage in the elbow, requiring surgery to remove it. Illustration by Steve Graepel.
Acute trauma can lift a chunk out of the synovial cartilage in the elbow, requiring surgery to remove it. Illustration by Steve Graepel.

I’ve been climbing for five years and in the last year have experienced considerable elbow pain around the medial epicondyle. I went to see a specialist who suggested I have PRP (platelet rich plasma) injections. They are rather expensive and even he didn’t sound convinced they’d work. Is it worth trying?

—Tom Barrows, via rockandice.com

Unfortunately, medicine is not just about your health—although I think most practitioners start out with this altruistic
approach. Market forces affect virtually everything in life, and medicine—because practitioners are typically big earners—is subject to
the market, too.

The invention of the hypodermic needle revolutionized not just the delivery of medicines but categorically shifted what could be achieved—and very
quickly. But injectable therapies for tendon pathologies are essentially the bastard child of financially driven medicine and human psychology. People
will usually try (and buy) a solution before doing any work themselves.

[Also Read Complete Elbow Health]

Autologous blood injections were the first iteration of this style of therapy and were proffered as the new great hope for people suffering tendinosis. Pushed hard in the 1990s, they have since floundered behind the next new great hope, PRP
injections. Prolotherapy entered the fray around the turn of the century but never really got its legs, probably because the injection of blood products
sounds way more fancy than that of sugar or saline solutions.

What little evidence there is for PRP in the general-research cosmos is feeble and fraught with methodological anomalies that would make a black hole envious.
Medicos may argue that public application of experimental therapies is all part of the great epidemiological study known as modern medicine, but I
would argue that the period of “guinea pig research” ended a decade ago at best. Move on, people.

PRP is medicine for the lazy or desperate. If you have money to burn, I suggest you just burn it at home and save yourself a trip to the doctor.


This article appeared in Rock and Ice issue 227 (July 2015).