I had medial (inside) epicondylitis in my right elbow for over 8 years before it finally went away (had 3 cortisone shots, acupuncture, physical therapy). I've also had low grade lateral (outside) epicondylitis in my left elbow for 8 years (still have it). I also have a new case of high grade lateral epicondylitis in my right elbow for the last 8 months.
Cortisone does not heal, it only masks the pain and you risk further injuring the elbow. I've had 4 cortsone shots (3 in one elbow and 1 in another). The first shot in each worked, but were only temporary. Cortisone is now thought to actually degenerate tissue. Cortisone is a powerful anti inflammatory and what they're discovering is that many cases thought to be tendonitis are actually tendonosis (or chronic tendonitis with no inflammation) I won't be getting anymore cortisone shots.
Tendons are like ropes and when they get over-used they begin to fray or tear. The body tries to repair the tendon, but because of limited blood supply in the area it takes a long time. So, people continue with their activity and the body eventually gives up and the cells begin to die. These micro tears turn into diseased tissue (scar tissue) and this is the cause of the pain in most cases.
Time will heal this in most cases (up to 85%), but again it takes a long time and you can't do your activity until it is healed or risk it becoming chronic. Several months or years in many cases depending on the injury and how quickly you heal as an individual.
About 3 years ago they discovered that eccentric excercises seem to help. The thought is the loading of the tendon while in a lengthened state re-models the tendon with the good collagen tissue. A study was done using rubber flex bars and the excercise is called the Tyler Twist (named after the physical therapist who developed it).
Eccentric Wrist Extension ('Tyler twist') - YouTube
http://www.youtube.com/watch?v=gsKGbqA9aNo
I started a thread awhile ago on a new procedure called the FAST procedure (Focused Aspiration of Scar Tissue). It was developed by doctors at the Mayo Clinic and the Emeritus Chief Orthopedic Surgeon Dr. Benard Morrey is the lead medical spokesperson for the procedure being marketed by Tenex Health.
It uses untrasound to target the diseased tissue (darker in color) and uses untrasonic energy (20,000 vibrations a second) to emulsify and remove the scar tissue (with a saline solution) without harming the health tissue. They use a probe the size of a tooth pick and the actual procedure where they're actually removing tissue is only a minute or two. The whole thing takes only about 15 minutes.
It's being marketed as extremely safe because of the minimally invasive nature of the procedure. You leave with a large bandaid and an ace bandage wrapped around your arm.
I had the FAST procedure done on June 26th. I had a lot of scar tissue and bone spurs. The doctor said he got ~ 80-85 percent of the bad tissue and much of the bone spurs. Mother nature takes over now and we'll see how it turns out.
It was only approved by the FDA last fall and as of early May they had done 1000 patients with over 90% success. I'm hoping I'm in that 90 percent group. Below is the website for Tenex Health and a You-Tube video of Dr. Morrey preforming the FAST procedure.
Tenex Health – Fast Procedure – fastprocedure.com: FAST procedure
FAST PROCEDURE-Complete procedure from diseased tissue v2 - YouTube