Using Stem Cells to Heal Elbow, Wrist, and Hand Pain

The most common elbow conditions that I see are tennis or golfer’s elbow, but other issues such as UCL injury or arthritis also occur. Surgical interventions lead to considerable downtime. Steroid injections may temporarily alleviate pain but ultimately causes more degenerations of tendons and over time leads to significant worsening of the condition. In addition, we have little solid scientific evidence that elbow surgery helps, but we do know it’s invasive and has the potential of infection, tissue damage, pain and nerve injury.

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow, also known as lateral epicondylitis, is a common condition that responds well to regenerative injections.  It often involves sprains of the annular ligament and the attachment points of the extensor compartment muscles, which are responsible for extending the wrist. While conventional treatment may include steroid injections, I advise against this approach as it can lead to long-term weakening of the ligament and tendon attachments. Regenerative healing makes more sense as you are addressing the underlying connective tissue problem with a connective tissue solution.

Conventional orthopedic opinion is that the tennis elbow is due to inflammation. This is actually not true. If you do a biopsy of a chronic tennis elbow and look at it under a microscope you do not see white blood cells, the hallmark of inflammation. Instead you see a lack of cells. Tennis elbow is a degenerative condition, not an inflammatory one. Hence a regenerative injection therapy that brings more blood flow and healing cells to the region makes a lot more sense than steroids and anti-inflammatories.   

In tennis elbow, the attachments of the annular ligament and extensor compartment muscles near the lateral epicondyle become stretched or torn. These weakened areas often produce a positive jump sign during palpation testing, making them very straight forward targets for injections of platelet-rich plasma or Prolotherapy. Typically, a few treatment sessions spaced a couple of weeks apart are sufficient in most cases. I generally reserve stem cell therapy for cases where the damage is severe or if the patient prefers to see me only once because they hate injections or have to travel so far to see me. Additionally, stem cell/PRP treatments may be considered for elite athletes who need to return to their sport as quickly as possible and want the fastest, best treatment as quickly as possible.

Tommy John Surgery is a surgery to reconstruct the ulnar collateral ligament (UCL), the ligament that holds the elbow together and stabilizes it. Injuries to the UCL are especially common in baseball among pitchers due to the incredible physical strain caused to the arm by pitching. The common treatment for pitchers suffering from tears in their UCL has been the Tommy John Surgery, a procedure that involves drilling holes in the ulna and the humerus and attaching a graft tendon taken from elsewhere in the body. Pitchers can typically begin throwing again after 18 weeks and will miss a full professional season in recovery. A percentage never return to play while some careers are cut short. 

With stem cells we inject the exact areas of damage in your elbow to repair damaged tissues and to improve function and mobility. Best of all, your downtime will be a fraction of surgery, with little to no need for opioid pain medications or time off of work. Gentle exercises that stretch the extensor compartment and light band work help with rehab. 

Golfer’s Elbow (Medial Epicondylitis)

Golfer’s elbow is very similar to tennis elbow, but in this case, it affects degeneration and strain of the flexor compartment muscles which attach at the medial epicondyle. Golfer’s elbow is also known as medial epicondylitis. The strained attachments are those of the flexor compartment muscles of the forearm which are responsible for flexing the wrist. The condition is typically confirmed using the “jump sign” during palpation testing, and these areas are ideal targets for regenerative injections by a skilled specialist.

Incidentally, during regenerative injection treatment, it’s essential for the doctor to be cautious and avoid the ulnar nerve, which runs behind the medial epicondyle, to prevent any complications. Make sure your doctor has done at least a hundred cases before you trust them.

Wrist, Hand, and Finger Pain

Most wrist, hand, and finger pain stems from joint instability. Until this instability is addressed, symptoms are likely to persist. Joint instability occurs when ligaments, which hold the joints together and allow proper movement, become overstretched or torn. This leads to destructive joint motions, similar to how a loose hinge on a door causes wear and tear. Joint instability is a key factor in almost all conditions related to hand and wrist pain.

Chronic pain in the wrists and hands is often linked to the repetitive tasks many people perform in today’s high-tech work environments. Certain sports and workouts can also aggravate pain when joints aren’t strong enough to handle the force. Additionally, conditions like “smartphone syndrome” and thumb pain have become more prevalent due to repetitive movements that strain the ligaments in the wrists and thumbs. Over time, these repetitive actions lead to loose joints, resulting in pain and stiffness.

Sudden injuries, such as damage to the triangular fibrocartilage complex (TFCC), can also cause joint instability. If left untreated or treated with conventional methods like cortisone injections or ibuprofen, these injuries are more likely to develop into chronic conditions, as these treatments can weaken the structures over time. Regenerative therapies offer a far better solution, promoting healing and restoring stability to the joints. If the pain is severe we generally suggest stem cell/PRP treatment over PRP or Prolotherapy alone as it works faster and better.

Basal Thumb Pain (CMC Joint Pain)

The carpal-metacarpal (CMC) joint, or basal thumb joint, is actually quite a common source of pain. This joint enables the opposable action of the thumb, which is essential for everyday tasks like holding objects, using smartphones, and opening jars. CMC pain can be quite debilitating because of how much we rely on this joint. Personally, I experienced this issue after spraining my CMC joint during a skiing accident, so I understand how disruptive it can be.

The pain is caused by CMC joint instability, which occurs when the joint partially dislocates (subluxates). If the pain is severe, I usually use stem cells / PRP injections to resolve the condition. For milder cases, a few sessions of Prolotherapy or PRP alone might suffice. Our success rate with regenerative injections is over 85%, and I consider it the preferred treatment of choice. In my opinion Regenerative healing gives far superior results to surgical stabilization, and is a much more elegant solution to an annoying problem.

Many years ago I had a patient who was a nurse and drove many hours to have treatment with me. She was ready to quit her job because she could not adjust IV knobs for her patients. I urged her to postpone any career decisions for a month or two to give us a chance to treat it properly. We did three or four sessions of Prolotherapy and she recovered full function of the thumb. (note: today I probably would have recommended stem cell/PRP because it works faster and a single session might have sufficed!).

TFCC Tears

The triangular fibrocartilage complex (TFCC) is a cartilage structure on the small finger side of the wrist that cushions and stabilizes the carpal bones, particularly during hand gripping and forearm rotation. TFCC tears can lead to chronic wrist pain and are categorized into two types:

• Type 1 tears are traumatic, often caused by falling on an outstretched hand or excessive forearm rotation.
• Type 2 tears are degenerative, developing over time due to wear and tear, aging, or inflammatory conditions like rheumatoid arthritis or gout.

Common symptoms include pain on the small finger side of the wrist, worsening with wrist movement, swelling, painful clicking, and loss of grip strength. TFCC tears are common among athletes who use rackets, bats, or put pressure on the wrist (e.g., gymnasts) and are more prevalent in people over 50. TFCC injury or pain responds readily to regenerative healing techniques. It’s always better to intervene as early as possible so I advise patients to consult a regenerative specialist as soon as they can, to avoid the condition worsening and becoming chronic. 

Finger Joint Pain

Our knuckle (MCP) and finger joints can become unstable due to injury or osteoarthritis (OA) over time. These joints can be treated with regenerative injection therapy to restore stability, reduce pain, and improve function. While regenerative injections won’t reverse any joint deformity, it effectively alleviates pain and enhances joint function.

Recap

As we can see, stem cells and regenerative injection therapies are very useful for all kinds of elbow, wrist and hand problems. Whether the problem is sprain, strain or OA, regenerative healing is safe and highly effective and in my opinion, will have far superior results than surgery or steroid shots.