Enthesopathy vs. Tendinitis (elbow)

I was being treated for classic Tennis Elbow when a very astute ultrasound technician found Enthesopathy (where the tendon attaches to the bone), and he believes that is my primary cause of pain. I was getting Prolotherapy treatments in order to avoid (or delay) surgery, and am starting to notice some improvement. My doctor restricted me from cycling (I'm an avid cyclist) and gardening.

I want to stress that my main complaint is not the pain itself -- the pain is only when I do certain movements/activities but very tolerable. My main concern is what is causing the pain and is it a sign of doing further damage? What's the worst damage that can occur, and, can I live with that and still be active (ride my bike, garden, knit, cook, bake)?

I'm wondering if Enthesopathy can be aided and improved by wearing a BandIT brace used for tennis elbow. Does it respond to traditional physiotherapy exercises? What is the best treatment for Enthesopathy? Has anyone had any success treating it without surgery?

Have you had physio at all? Usually tennis elbow resolves very well without surgery. I'd look at the enthesopathy as part of the whole tennis elbow package. In the literature tennis elbow is aka lateral epicondilytis and is aka enthesopathy of the elbow.

There are numerous physio approaches to tennis elbow:

Release the muscles involved via some type of massage: soft tissue release, trigger point release, etc.
Appropriate stretches.
Acupuncture.
Ultrasound affected tendons. Some may cross friction the tendons.
Mulligan techniques for tennis elbow.
Strengthening with eccentric exercises.
The strap you mentioned.
Ergonomic assessment work/sport.

That's just a basic approach. I'd go see a physio to see if you can resolve the problem before resorting to surgery.

Sorry, didn't address the worst case scenario. I wouldn't go in that direction as an option as it is so easy to release and relieve tennis elbow. What does happen as things worsen is you end up with many micro tears in the tendinous tissue. This causes weakness in the tissues and leads to scarring/adhesions. Eventually pain would stop you from doing many daily activities.

Enthesopathy may be a sign of a systemic rheumatological disorder. It might be worth chatting to your doctor and getting some blood tests done to rule out a systemic pathology if they think this is warranted.