Elbow pain that shows up on every backswing
StemWave plus ultrasound-guided PRP at FirstCall DPC, Santa Rosa Beach
See if I'm a candidateFor an elbow, that means we look at the tendon where it attaches to the bone, check for a tear, and make sure the pain is not coming from the joint or the nerve next to it. Tendon pain that has lasted months is usually a worn tendon, not an inflamed one, and that changes what works.
Is this you?
- It hurts to shake hands, turn a doorknob or lift the coffee pot.
- You have tried the strap, the rest and the ice. Three months in, nothing has changed.
- You had a cortisone shot. Six weeks of relief, then it came back worse.
- Your grip is the first thing to go in the third set.
- You keep playing because stopping does not seem to help either.
If this started last week, you do not need PRP. You need a few weeks of the right exercises, and I will give them to you for free.
How it works
1.Exam and ultrasound
I test the tendon with your wrist and fingers loaded, then look at it on ultrasound. We can see the thickened tendon, the small tears and the new blood vessels that show up when a tendon has been struggling for a while.
2.StemWave sessions
Three StemWave sessions over about two weeks before the injection. The focused acoustic wave is aimed at the worn part of the tendon we found on ultrasound. It is a fifteen-minute visit with Ronna, uncomfortable for a few seconds at a time, no downtime.
3.PRP under ultrasound
We draw your blood, spin it, and inject the platelet layer directly into the worn part of the tendon while watching on the screen. This is the one place where guidance matters most. The target is a few millimeters wide.
4.Loading plan
You start a slow, heavy wrist program within a week. It feels backward to load a tendon that hurts. It is also the part of the plan with the best evidence, and PRP without it is half a treatment.
For tennis and golfer's elbow we use the Reset package: three StemWave sessions, then one ultrasound-guided PRP injection within two or three days of the last session, then the loading program. If the tendon is badly worn on ultrasound, Dr. Petersen may move you to the Rebuild package. Expect it to feel worse for a week, then improve over two to three months.
What the evidence says
Tennis elbow is where PRP has the best track record. In the larger trials it beat cortisone at six months and beyond, because cortisone helps fast and then fades while PRP keeps improving. It is not a miracle. About a quarter of patients do not get a meaningful change, and I will tell you that before you decide.
“If I ever have to exaggerate the evidence to justify offering something, I probably shouldn't be offering it.”Dr. Petersen
What it costs
- Rebuild6 StemWave sessions + 1 ultrasound-guided PRP injection$1,895
- Elite Recovery10 StemWave sessions + 2 ultrasound-guided PRP injections$2,995
FirstCall DPC members get 15% off every package.
The exam and the ultrasound are included. HSA and FSA accepted. Financing available.
Dr. Petersen chooses the package at the exam based on what the ultrasound shows. If a single ultrasound-guided PRP injection without StemWave is the right call for you, that is offered through the main practice and he will say so.
Here is the honest version. Tennis elbow is not inflammation. It is a tendon that has been pulled on too much for too long and has stopped repairing itself properly. That is why rest does not fix it and why cortisone, which calms inflammation, helps for a few weeks and then stops.
PRP puts your own platelets into the tendon to restart the repair. The loading program finishes the job. If you only want one of the two, pick the loading program. If you want this fixed, do both.
Meet the physicians
Erik Petersen, DO
Board-certified in Internal Medicine. Twenty years of emergency medicine, and the person holding the ultrasound probe.
Co-founder of FirstCall DPC. Former All-American football player who still thinks a loading program beats a shortcut.
Will Carlson, MD
Board-certified in Internal Medicine. Emergency medicine experience, and the slower, more careful half of this partnership.
Co-founder of FirstCall DPC. He is the one who asks what happens if we are wrong, which is why we rarely are.