After six steroid injections for tennis elbow, I saw a report that it isn't an inflammatory problem after all. What's up with that?

Tennis elbow or epicondylitis can cause painful symptoms on the inside or outside of the elbow. Lateral epicondylitis along the outer border of the elbow is the most common form. It's always been assumed that this condition occurs as a result of tendonitis.

However, scientists studying cells from muscles and tendons around the elbow don't find any sign of inflammation. Instead, chronic overuse of the muscles results in damage to the tendon cells that don't heal.

Using a microscope, researchers find large numbers of fibroblasts. These are the "baby" cells of soft tissues. They don’t seem to "grow up" or mature after injury. A loss of blood supply may also add to the problem.

These findings have changed the way doctors treat epicondylitis. Instead of ice or drugs to calm the inflammation, the elbow is injected with the patient's own blood. Special chemicals in the blood start the healing process.