stem/ skin cells to cure tennis/golfer elbow

[gcoe]

Hi João

You probably have read of a very small phase I trial of a 12 patients who had long standing tennsis elbow that didn't respond to treatment. The treatment involved one injection of a culture of collagen-producing cells derived from skin fibroblasts

http://bjsm.bmj.com/content/43/4/293.full

The results from the trial are promising as 11/12 both reported benefits and demonstrable benefits on a number of tests that examined the quality of the tendon.

Phase I trials like this are designed to test the safety of the procedure as it is the first time an experiment of this type has been conducted on humans. It is not designed to test the effectiveness of the treatment as it is too small and there was not control group or sham group who believed they were getting a treatment but didn't. Furthermore the people who conducted the testing were aware of the procedure the patients went though and this introduces bias. It is a sad fact of life that more often than not such treatments turn out to be less effective when good quality clinical trials are conduted.

It will no doubt be a while before such a treatment has been shown to be worthwhile and will become available. The long term effects of the treatment remain unknown. For example could the injection induce cancers later.

If you do find an institution providing such treatment I would approach it with great caution. It would be unethical for such an institution or Dr to offer such treatment and the chances are the place is looking for making some big money and may not be offering truly valid stem cell therapy.

I do appreciate the tennis elbow is some times difficult to treat. However there are a number of treatments in physiotherapy that seem to work in the long term. The other option is corticosteroid injection which can be effective , particularly in the short term. How long have you had the problem and what treatment have you had so far?

In addition I wonder if the diagnosis is right? You usually don't have both golfers + tennis elbow + ulnar nerve involvement although it is possible.

[joaomiguel]

Hi,

Thank you for replying.

I did my injured one year ago. Unfortunately, the pain is in the outside and also in the inside of the elbow (I also have pain in the wrists). I also feel my elbows numb sometimes, and a burning sensation ocasionaly in my forearms, and that is what concern me the most. I'm affraid I'm damaging the nerve.

I did my exercices at home with no supervising of anyone. I also didn't worm up. I know, it sounds nuts! However, I did a EMG, and it was normal. I think maybe, my injure is irritating my ulnar nerve. I don't know. I also have my elbows cracking when I spread my arms. I never had this. The RX was normal, and also the Ecography.

I'm desperated. I think the massage of a therapist/movements of the elbows worsen my ulnar nerve condition.

By the way, have you heard about Plasma rich palatelet? Does it cures Tennis elbow/tendinosis?

Thank you,

Joao

[gcoe]

Hi Joao

I did my injured one year ago.

Was there an incident or did the symptoms come on slowly and just got worse?

Unfortunately, the pain is in the outside and also in the inside of the elbow (I also have pain in the wrists). I also feel my elbows numb sometimes, and a burning sensation ocasionaly in my forearms, and that is what concern me the most. I'm affraid I'm damaging the nerve.

I am not sure that the diagnosis is right. You generally either have symptoms on the outside (tennis elbow) or on the inside (golphers elbow). You don't normally have numbness or burning sensations in the elbows. Furthermore the fact that it involves both elbows is on both sides points to another problem. With the burning in the forearms and numbness this does suggest a neural problem. thigns that come to mind are:

1. overuse process problem such as large amounts of computer work. This is a more diffuse problem often linked to sitting posture and there may be involvement of the nerve complex in the arms.
2. bilateral nerve entrapment but this seems a bit unlikely as you have both arms involved
3. Neck problem with nerve involvement.

Points 1 or 3 seem most likely

I did my exercices at home with no supervising of anyone. I also didn't worm up. I know, it sounds nuts! However, I did a EMG, and it was normal.

EMG testing can be normal when nerve problems are not very far advanced. There are some clinical tests that a physiotherapist can do that may reveal nerve involvement.

I think maybe, my injure is irritating my ulnar nerve.

Couold be iif the symptoms are on the little finger side of the forearm or if you have numbness or pins and needles on the little finger side of the par of the hand and the ring and little fingers.

I also have my elbows cracking when I spread my arms. I never had this.

ARe the cracking painful? If not this is not uncommon and in itself is usually nothing to worry about. Joints often crack when they under more muscle tension around them changes and lots of people notice this sort of cracking. If the cracking is painful that is another matter.

The RX was normal, and also the Ecography.

The ultrasound test should identify

I'm desperated. I think the massage of a therapist/movements of the elbows worsen my ulnar nerve condition.

I don't know how thorough your physiotherapy was. However I think you need a really good clinical diagnosis based on your history and a detailed examination that includes looking at the neck and arms and includes looking at joints, muscles, tendons and nerves.

By the way, have you heard about Plasma rich platelet? Does it cures Tennis elbow/tendinosis? [/QUOTE]This is a treatment that has been around for a while. There are no proper clinical trials I could find for it so I would be cautious about trying it. I would not recommend it on that basis. However if you did want to try it make sure that you are in a proper facility that handles blood products. I understand the Did you find it on the internet? The blood is harvested from you, centrifuged then injected into the painful tendon. Just remember even though this is your own blood you should not be taking any risk with acquiring blood-borne pathogens - HIV and Hepatitis B & C being some of the worst.

Anyway you need to get it properly diagnosed first