The elbow joint is a complex hinge where the humerus (upper arm bone), radius, and ulna (forearm bones) meet. On the outside of the elbow is a bony bump called the lateral epicondyle. Several forearm muscles that extend the wrist and fingers originate from this area. The primary tendon involved in tennis elbow is the extensor carpi radialis brevis (ECRB). This tendon attaches to the lateral epicondyle and helps stabilize the wrist when the elbow is straight.

When this tendon is overused through sports, manual labor, or everyday activities like typing, gripping tools, or lifting objects the tendon can develop small tears and degeneration. Over time, this leads to inflammation, pain, and tenderness at the outer elbow.

Tennis elbow is typically caused by repetitive motions that strain the forearm muscles and tendons. This can include:

• Repeated wrist extension and gripping (common in racquet sports, plumbing, carpentry, painting, and typing)
• Improper technique during physical activity (especially in tennis and similar sports)
• Muscle imbalances or poor ergonomics at work
• Direct trauma or strain from lifting a heavy object

While common in adults between 30 and 50, tennis elbow can affect all ages. The pain often starts gradually and may worsen with continued activity. Patients often report discomfort when shaking hands, turning a doorknob, lifting a cup, or using tools.

Many cases of tennis elbow improve with non-surgical care. At Vitality Orthopedics and Biologics, we begin with a comprehensive evaluation to assess your symptoms, lifestyle, and goals. A personalized care plan may include:

• Activity modification and bracing: Reducing or adjusting the activities that aggravate symptoms is an important first step. A counterforce brace or wrist splint may be recommended to reduce tendon strain during movement.
• Physical therapy: Guided exercises help stretch and strengthen the forearm muscles while improving flexibility and reducing stress on the affected tendon. Eccentric strengthening exercises, in particular, have been shown to promote tendon healing.
• Ice therapy and anti-inflammatory support: Applying cold packs and using topical or oral anti-inflammatory agents can help reduce swelling and discomfort during flare-ups.

In cases where symptoms persist despite conservative measures, regenerative medicine can offer a more targeted approach to healing by supporting the body’s natural repair mechanisms. Vitality Orthopedics and Biologics offers several evidence-based regenerative therapies, including:

Red light therapy (photobiomodulation)

This treatment uses low-level red or near-infrared light to stimulate cellular activity and improve blood flow to injured tissues. Red light therapy may reduce inflammation and promote tissue repair, helping relieve pain and support tendon recovery.

Laser therapy

Similar to red light therapy but using focused laser wavelengths, this treatment penetrates deeper into tissues to reduce inflammation, increase circulation, and support collagen remodeling within the tendon. It is non-invasive and well tolerated by most patients.

Hyperbaric oxygen therapy (HBOT)

By delivering concentrated oxygen in a pressurized chamber, HBOT helps increase oxygen delivery to damaged tissues. This may support faster healing of the degenerative tendon tissue seen in tennis elbow and help reduce chronic inflammation.

Platelet-rich plasma (PRP) injections

PRP is derived from the patient’s own blood and contains a concentrated mixture of platelets and growth factors. When injected into the damaged tendon, PRP can stimulate tissue regeneration and reduce inflammation. This is a popular option for patients who want to avoid corticosteroid injections or surgery.

Bone marrow aspirate concentrate (BMAC)

BMAC involves harvesting stem cells and growth factors from the patient’s own bone marrow. These biologic materials are then injected into the damaged area to enhance tendon healing and reduce symptoms. BMAC may be appropriate for more severe or chronic cases of tennis elbow.

BPC-157 peptide therapy

BPC-157 is a synthetic peptide derived from a natural protein found in the stomach. It is known for its regenerative properties, including promoting tendon and ligament healing, reducing inflammation, and supporting angiogenesis (formation of new blood vessels). When used as part of a treatment plan, BPC-157 may offer additional healing support for patients with tennis elbow.

Before beginning any treatment, patients should receive a full clinical assessment, which may include a physical exam and diagnostic imaging. Not every patient requires regenerative therapy, but for those who do, it is essential to discuss the expected outcomes, timing, and insurance coverage. Most regenerative treatments are performed on an outpatient basis with little to no downtime, though multiple sessions may be required depending on the therapy selected.

Patients who are active, work with their hands, or are motivated to avoid surgery often find regenerative medicine an appealing option. However, results may vary, and realistic expectations are important. Healing can take weeks to months, depending on the severity of the injury and the treatment approach.