Tennis elbow — lateral epicondylitis — is one of the most common causes of persistent elbow pain, and one of the most frustrating. It rarely resolves with rest alone, it interferes with everything from a backhand to carrying a grocery bag, and the standard first answer, a cortisone shot, often works brilliantly for a few weeks and then stops.
Platelet-rich plasma is among the most thoroughly studied applications of PRP anywhere in orthopedics, and tennis elbow is where the evidence is strongest. At our Miami clinic, Dr. William Bonner — a credentialed Regenexx provider — performs ultrasound-guided PRP injections for elbow tendon pain, targeting the specific damaged tissue rather than the general area.
PRP may be appropriate for a number of elbow problems, including:
If you are not yet sure what is causing your elbow pain, start with our overview of non-surgical elbow pain treatment in Miami.
The name is misleading. Despite the “-itis,” this is not primarily an inflammatory condition.
What is actually happening at the outside of the elbow is tendinosis — a degenerative change in the tendon where healthy, organized collagen is gradually replaced by disorganized tissue and immature blood vessels. The tendon has not simply become irritated; its structure has changed.
That distinction matters enormously for treatment. Anti-inflammatory medication and cortisone both target inflammation, which is largely not the problem. It explains the pattern most patients describe: real relief for a few weeks, then a return to baseline, sometimes worse than before.
PRP works on a different mechanism. Concentrated platelets release growth factors that recruit the cells involved in tendon repair, prompting the body to attempt a healing response in tissue that has effectively stopped trying. It is slower than cortisone. It is also aiming at the actual problem.
We would rather give you the honest version than the marketing one, because the honest version is still good.
A 2025 meta-analysis pooled 26 randomized controlled trials covering 1,877 patients comparing PRP against corticosteroid injection for lateral epicondylitis. The findings were consistent and nuanced:
A separate systematic review of systematic reviews reached the same conclusion: cortisone works faster, PRP works better over time, and PRP is the more effective long-term option for patients who have already failed conservative management.
So if your only goal is to feel better for your tournament next weekend, cortisone is the faster tool and Dr. Bonner will tell you so. If you want the tendon to be better in a year, the evidence favors PRP.
Both have a role. They are not interchangeable, and the choice depends on what you are optimizing for.
This is where outcomes are won or lost, and it is the part almost nobody asks about.
A thorough evaluation comes first. Dr. Bonner takes a full history, examines the elbow directly, and personally reviews all of your imaging. Lateral elbow pain is not always the extensor tendon — it can involve the radiocapitellar joint, the lateral collateral ligament complex, or nerve entrapment that mimics tendinopathy almost perfectly. Injecting the tendon when the problem is elsewhere produces exactly the disappointing result patients then blame on PRP.
Every injection is image guided. The elbow is a small joint with closely packed structures, and the target in tennis elbow is often a discrete area of degeneration within the tendon rather than the whole tendon. Ultrasound lets Dr. Bonner see the damaged tissue and the needle tip simultaneously and confirm placement before anything is delivered. Landmark-based injection by feel misses its target far more often than patients realize.
Every involved structure is treated. If the exam and imaging show tendon degeneration and ligament involvement, both are addressed. A single injection into the general area leaves part of the problem untreated.
The PRP itself is processed under Regenexx laboratory protocols to a far higher and more consistent platelet concentration than a bedside centrifuge can produce — up to 20 times baseline, and typically around 14 times for the injections we perform.
Still have a question? Call 786-522-4959 or request a consultation.
Slower than cortisone. Most patients notice meaningful change between six and twelve weeks, with continued improvement after that. If you need relief by next week, this is not the right tool, and we will say so.
Many patients do well with one. Some need a second. That depends on how degenerated the tendon is on imaging and how you respond, which is why we do not quote a treatment plan before examining you.
The treatment itself is not — insurers in the United States still classify PRP as investigational. Your evaluation is billed through your insurance like any other specialist visit, and we are in network with most major plans. We explain how cost works on our PRP and stem cell treatment cost page.
Yes. Prior cortisone does not rule you out. We generally allow an interval between a steroid injection and PRP so the steroid is not working against the healing response we are trying to create. Dr. Bonner will advise on timing based on when yours was done.
There is discomfort during and for a few days after, more than with cortisone. The injection targets degenerated tendon, and a healing response is by nature an inflammatory one. Most patients describe a soreness that settles within a week.
Bring whatever imaging you have. Dr. Bonner reviews all of it personally, along with diagnostic ultrasound in the office when it adds something your existing imaging does not show. If something important is missing, he will tell you before any treatment is planned.
You will be asked to avoid loading the tendon heavily for a short period, and anti-inflammatory medication is usually withheld because it works against the mechanism. You will not be immobilized, and most people return to desk work immediately.
If tennis elbow has not improved with rest, bracing or physical therapy, or if a cortisone injection helped and then wore off, an evaluation is the sensible next step — and it is billed through your insurance.
Contact our Miami clinic to schedule with Dr. Bonner, or call 786-522-4959. You will leave knowing what is actually wrong with your elbow and whether PRP is a reasonable option for it.
We do not quote prices over the phone, because the right treatment depends on what your exam and imaging actually show. We do explain exactly how cost works, why price comparisons between clinics are misleading, and why your evaluation is billed through your insurance.
Read our honest answer on PRP and stem cell treatment cost in Miami
