I-170 NORTH
Olivette is one of the shorter runs to our PRP and orthobiologic clinic, about eighteen minutes up I-170 to Natural Bridge Road. Tennis elbow in someone who has never played tennis is the most common referral we get from office workers.
Getting here from Olivette
I-170 north to Natural Bridge Road — about eighteen minutes, one of the shorter runs in our area. Parking outside the door.
Can you get tennis elbow from typing or using a mouse?
Lateral epicondylitis (tennis elbow) is named for a sport most people with it do not play. What causes it is repeated gripping and bending the wrist back (extension) under low load for long periods — a mouse, a keyboard, a phone held for hours.
As with other chronic tendon problems, the -itis is misleading. In the lasting phase, the tissue shows degeneration (breakdown), not inflammation. That is why anti-inflammatories and rest disappoint. It is also why it comes back the moment the work starts again.
Tennis elbow covers the tissue changes. Golfer’s elbow covers the inner (medial) version, which is the same problem on the other side.
Why the brace did not fix it
A counterforce brace takes load off the tendon during use. It is truly useful, and it treats nothing — the moment it comes off, the tissue is unchanged.
The same goes for wrist splints and ergonomic mice. They are load management. That is needed but not enough. Mistaking them for treatment is why this drags on for a year.
Does PRP work for tennis elbow?
Lateral epicondylitis is one of the better-studied uses for orthobiologic injection. The results are still not uniform. Why the trials disagree covers the reasons — mostly preparation, dose and whether a loading program ran alongside.
What is consistent is that injection without eccentric loading (slow, lengthening strength work) does worse. The injection triggers a repair response. The loading tells the tissue how to organize it.
The wrist and the neck
Forearm and elbow pain with any numbness or tingling is not simply a tendon problem. The nerve has to be accounted for. Pressure on a nerve at the wrist, at the elbow, or in the neck can all cause it. More than one can be present at once.
That is worth settling before an injection is aimed at a tendon that may not be the whole story.
Grip is the measurement
Grip strength is the most useful objective marker in this problem. It is repeatable, it tracks with function, and it moves when treatment is working.
We record it at the start for exactly that reason. Without a number, judging progress in an elbow comes down to how the last few days felt. That is a poor tool.
Why does tennis elbow keep coming back?
Elbow tendon problems follow workload, and workload is seasonal for most desk jobs. A problem that cleared up over a quiet summer and came back in September did not relapse. It was reloaded.
That pattern is worth spotting, because it makes the case for keeping up the loading program rather than stopping it when symptoms settle.
The measurement that matters
Pain-free grip strength is the marker we track. It is objective and repeatable. It moves before the feeling of pain does. That makes it the better early signal of whether treatment is working.
Without a number, judging an elbow comes down to memory. Memory is unreliable in exactly the direction people hope.
When it is the nerve
Forearm pain with numbness or tingling is not a simple tendon problem. The radial nerve can be trapped in the same area that causes lateral (outer) elbow pain.
Injecting a tendon for a nerve problem brings the non-response people describe when they arrive here.
What desk changes help tennis elbow?
Keep the mouse closer to the body. Use a lighter grip. Break up long gripping before symptoms arrive, not after. And use voice input where the work allows it.
None of that treats the tendon. It keeps the treatment from being undone eight hours a day. That is the difference between a result that holds and one that lasts a month.
What a course actually involves
An assessment, the procedure, and a loading program with review points. Not a series booked in advance, which is a sales structure rather than a clinical one.
What to expect sets out the visit itself. The risks covers what can go wrong, which is a short list and not an empty one.
The ceiling nobody measures
Desk work and metabolic health travel together more often than anyone likes. Connective tissue repair is one of the first things to suffer. The metabolic side explains that link.
How is golfer’s elbow different from tennis elbow?
Everything above is about the outside of the elbow. The inner side has its own version. It is worth telling apart, because the anatomy under it is not the same.
Medial epicondylalgia involves the shared starting point of the forearm muscles that bend the wrist and turn the palm down (the common flexor-pronator origin). It follows the same degenerative pattern as the lateral (outer) form. It is less common. It responds to the same rules — load management, steadily building strength in the wrist flexors and pronators, and time measured in months.
The catch is what sits beside it. The ulnar nerve runs right behind the medial epicondyle, in a groove where it sits close to the skin and is easily irritated. Ulnar nerve symptoms show up with medial (inner) elbow pain often enough that the two are regularly confused. Numbness or tingling into the ring and little fingers points to the nerve, not the tendon. So do symptoms that are worse with the elbow held bent, or a weak grip.
That changes both the treatment and what should be injected near the area. Anything placed on the medial (inner) side is placed with that nerve in mind. That is one of the clearer reasons for image guidance rather than landmarks.
Frequently asked questions about PRP near Olivette
I do not play tennis. Can I still have tennis elbow?
Yes, and most people with it do not. Repeated gripping and bending the wrist back cause it: the mechanism.
Why has my brace not fixed it?
A brace manages load during use. It does not change the tendon. It is a useful add-on, not a treatment.
How many injections will I need?
Fewer than most places will sell you. We do not book a course in advance. We check the response, and the plan changes if it is not working.
How far is it from Olivette?
About eighteen minutes straight up I-170, with parking at the door.
Is tennis elbow caused by inflammation?
Not in the long-lasting phase. The name ends in -itis, but in lasting tennis elbow the tendon shows degeneration (breakdown), not inflammation. That is why anti-inflammatory pills and rest tend to disappoint. It is also why the pain comes back the moment the gripping work starts again. Treatment has to change the tendon itself, and that is what loading does.
Could my forearm pain be a pinched nerve instead?
It can be. Forearm or elbow pain with any numbness or tingling is not a simple tendon problem. A nerve can be pressed on at the wrist, at the elbow or in the neck. More than one can be involved at once. The radial nerve can be trapped in the same area that causes outer elbow pain. Injecting a tendon for a nerve problem does not work.
How do you know if tennis elbow treatment is working?
We measure pain-free grip strength. It is objective and repeatable. It tends to improve before pain does, so it is an early signal of whether treatment is working. We record it at your first visit for exactly that reason. Without a number, judging an elbow comes down to how the last few days felt, and memory is a poor tool.
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12174 Natural Bridge Rd, Suite 303
St. Louis, MO 63044