Does PRP for Tennis Elbow Really Work?
Tennis elbow, or lateral epicondylitis, is among the most common causes of elbow pain — and it strikes anyone active in sport or work, not just tennis players. Treatment starts with activity modification, exercise, and shockwave. When these fail, injections follow, and a PRP injection for tennis elbow has become the leading option since the evidence turned against cortisone.
Dr Masci performs platelet rich plasma for tennis elbow under ultrasound guidance at his London clinics, as a one-stop visit. So does PRP for the elbow actually work, which formula works best, and what should you expect? This guide covers it all.
How do we diagnose tennis elbow?
History and examination usually make the diagnosis. Pain sits on the outside of the elbow, with tenderness near the lateral epicondyle and pain on resisted upward wrist movement. Ultrasound or MRI helps rule out the mimics: elbow arthritis, radial nerve entrapment, elbow instability, and referred neck pain. Our full elbow tendonitis guide covers the condition in detail.
Simple treatments come first
Most cases respond to activity modification, oral ibuprofen, a tennis elbow brace, and exercises strengthening the forearm and shoulder. GTN patches add benefit, and shockwave helps some stubborn cases.
What about cortisone? Avoid it. People who have a cortisone shot for tennis elbow do worse than those who do nothing — our tennis elbow injection guide explains the evidence. So if cortisone harms, what about PRP?
What is PRP?
Platelet-rich plasma comes from your own blood. Platelets carry a high concentration of growth factors that drive tendon healing and regeneration.
How do we perform a PRP injection for tennis elbow?
We draw 15–30 ml of blood from your arm and spin it in a centrifuge, separating the platelet-rich plasma from the red cells. Dr Masci then injects the plasma into the focal area of tendon damage under ultrasound guidance — accuracy decides whether the growth factors reach the diseased tissue. Depending on the PRP system, one or two injections complete the treatment.
What is the evidence for PRP for tennis elbow?
The evidence increasingly supports PRP — with caveats. Dr Masci has co-authored a review of the evidence for tendon injections. A review comparing PRP with cortisone in tennis elbow found PRP delivers better, longer-lasting relief. However, a Cochrane review found PRP no better than placebo or other injections, so the picture stays mixed.
The PRP formula may explain the mixed results. A recent review found high white cell count PRP outperforms low white cell PRP for tennis elbow, and a broader review of tendon studies agrees. Achieving this requires more blood (30–60 ml), spun twice to superconcentrate the platelets and white cells. We prefer Arthrex ACP Max, a second-generation system delivering a superconcentrated platelet dose with the white cell concentration adjusted for tendon work — in a single injection.
How many PRP injections do you need for tennis elbow?
It depends on the system. Low-platelet-concentration PRP needs 2–3 injections, spaced about a week apart. Superconcentrated high-dose PRP — such as ACP Max — needs one.
How much does PRP for tennis elbow cost in London?
At Dr Masci’s Chelsea clinic, standard PRP costs £510 for the first injection and £410 thereafter; ACP Max superconcentrated PRP costs £1,350 as a single injection. Every fee covers a one-stop visit: consultation, diagnostic ultrasound, and injection. Other clinic locations cost more. Full fees here.
How long should you rest after PRP for tennis elbow?
Expect tenderness at the injection site — this is normal. Ice regularly, take paracetamol for a few days, and rest the elbow for about a week after each injection. The tendon often feels sore for up to four weeks before improving.
A typical recovery timeline:
- Days 0–2: rest the elbow; regular ice and simple analgesia
- Days 3–7: re-engage with lower-body activity — gym, cycling, running
- Days 8–14: restart tennis elbow exercises; physiotherapy review at ten days
- Days 14–28: progress tendon loading and light upper-body weights
- Day 28 onwards: resume heavier upper-body weights, guided by your therapist
Read our full guide to PRP injection recovery time.
Are PRP injections in the elbow painful?
Generally, yes — during and after. Local anaesthetic destroys platelets, so we use as little as possible, which makes PRP more uncomfortable than a cortisone injection. The tendon can also feel worse for the first few weeks; ice the elbow for the first 48 hours. This flare settles, and improvement follows. A minority of people do not respond and need other treatment.
Can I drive after a PRP injection for the elbow?
No — the post-injection flare is significant, so avoid driving for at least 12 hours after the injection.
PRP vs surgery: which wins for tennis elbow?
The evidence for PRP isn’t perfect — but surgery’s is worse. A study of tendon surgery found it no better than physiotherapy, with more adverse events, and in tennis elbow specifically, surgery performed no better than sham surgery. Exhaust conservative treatment — including PRP — before considering an operation.
Are there alternatives to PRP for tennis elbow?
Yes. Percutaneous needle tenotomy repeatedly needles the damaged tendon under ultrasound, stimulating a healing response. Unlike PRP, we can use local anaesthetic freely, making it more comfortable. Studies show needle tenotomy works for tennis elbow, and it costs less than PRP — many doctors consider it the first-choice injection. Like PRP, the elbow often feels worse before it feels better, with effects from about four weeks.
What about tendon tears? Small tears are common in longstanding tennis elbow and need the same treatment as tendonitis — our tennis elbow injection guide covers tears in detail.
Final word from Sport Doctor London about platelet rich plasma for tennis elbow
PRP for tennis elbow is safe and increasingly well-supported — but only after simpler treatments fail, because most people improve without any injection. When you do need one, our preferred option is a single shot of superconcentrated PRP with the white cell formula matched to tendons: Arthrex ACP Max.
To book a one-stop PRP injection for tennis elbow in London, contact Dr Masci’s team here or call +44 (0) 203 488 0350.
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