Could plastic beads banish tennis elbow?

Small plastic balls injected into the arm can banish the pain of tennis elbow.

Up to two million people in Britain have tennis elbow at any given time, which is caused by repetitive arm movements, including those involved in sports.

As the blood flows into the troubled joint, it carries inflammatory cells that can exacerbate any existing swelling and inflammation, exacerbating the discomfort and pain.

In a new approach, thousands of tiny plastic balls – each no wider than a human hair – are used to ease this pain.

When injected into the artery that feeds the elbow, the beads clump together, restricting, but not completely blocking, the amount of blood flowing into the joint (some blood is needed to bring oxygen and nutrients to the area to help it heal). The idea is that this partial blockage reduces the amount of inflammatory cells that can get through, dampening the inflammation and pain.

A trial of the technique involving 25 patients with tennis elbow began in March at the University of California at Los Angeles (UCLA).

Tennis elbow, or lateral epicondylitis, develops when tendons — tough cords of tissue that connect muscle to your bone — become damaged, often from overuse. The main symptom is pain on the outside of the elbow, and the condition can be so debilitating that it is difficult to perform everyday activities, such as driving. Even in mild cases, the pain can last for two to three weeks and spread to the upper and lower arm.

Treatment includes painkillers and anti-inflammatories. But many people find that the pain returns once they resume the activity that caused the pain.

Another option is steroid injections to reduce swelling in the tendons. This may take a few weeks to work, and some people need two to three shots before it is effective. Further, a 2006 study in the BMJ found that the injections were no more effective than exercise and physical therapy.

The new procedure, called arterial embolization, which is normally performed under local anesthesia, is already widely used for other health conditions; to shrink an enlarged prostate (a common problem as men age), starve tumors of the oxygen they need to grow, and reduce painful growths, such as uterine fibroids.

Prior to the procedure, the number and size of the beads is carefully calculated to reduce blood flow but not completely starve the elbow joint. The granules, which are biocompatible (ie they do not harm healthy tissue) remain permanently in the artery. Possible side effects include bleeding, infection, or injury to the treated artery.

In the new UCLA study, patients with tennis elbow undergo an hour-long infusion of tens of thousands of plastic spheres into a blood vessel that feeds the elbow and are monitored every three and six months. The trial is expected to run until 2027.

The US researchers hope to replicate the results of a similar 2019 study in Japan, where more than half of the 52 volunteers who underwent this treatment experienced a significant reduction in pain and mobility.

Philip Conaghan, a professor of musculoskeletal medicine at the University of Leeds, said blocking blood vessels in this way could also prevent adjacent nerves from working properly, interrupting pain signals.

“There is some rationale for this therapy, but the trial will have to see if there are any benefits and how long they last.” It will also need to monitor side effects, as there is a risk that the blood vessels that supply blood to the skin may become blocked, causing thinning or ulceration of the skin.’

Injecting tiny plastic balls into the knee can also relieve arthritis, say American researchers.

When 350 patients underwent the procedure, most experienced almost immediate pain relief that lasted at least a year after treatment, reports the journal Cardiovascular and Interventional Radiology.

Similar to tennis elbow, the treatment works to reduce blood flow so fewer inflammatory cells enter the damaged knee joint.

Secrets of an A-list body

This week: the shoulders of Catherine Zeta-Jones

Catherine Zeta-Jones wore an off-the-shoulder dress to a Hollywood photo call last week. The mother of two, 53, keeps fit by working out five times a week, with a particular focus on tap dance, ballet and hula hoops. Her home gym has a treadmill, elliptical, Peloton bike, and a pool — “I don’t need anyone to motivate me,” she’s said.

What to try: The wall pushup will gently sculpt your shoulders and chest.

Stand a few steps away from a wall, facing it, with your feet together (step farther away for a bigger challenge). Place your hands in a diamond shape on the wall in front of your face. Maintaining a plank position, slowly bring your chest toward the wall. Press back.

Complete ten reps daily – and when you’re ready to raise the bar, try using one arm at a time.

Try this…

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Ole uses new tricks

Existing medicines with new applications. This week: Blood pressure pills for dementia

Amlodipine has been used for decades to treat high blood pressure – it works by relaxing and widening blood vessels so that blood can flow more freely, reducing the risk of clots.

But in 2021, scientists at the University of Manchester found that the drug could also stop vascular dementia, which affects around 150,000 people in the UK. This is activated when the brain is deprived of oxygen because the blood vessels in the head constrict over time due to high blood pressure.

In tests on mice with vascular dementia, they found that amlodipine stopped the progression of the disease, the Journal of Clinical Investigation reported. It is thought to work by stimulating the activity of a protein called Kir2.1 found in cells lining blood vessels, which helps keep blood flowing properly.

The Manchester team now hopes to try amlodipine in people with the condition in the coming years.

Shortness of breath that lasts months after a covid infection may be due to poor sleep and is not long covid, The Lancet Respiratory Medicine reports.

Researchers from the University of Manchester followed more than 600 adults who reported suffering from long-term Covid symptoms, such as breathing difficulties, and found that nearly two-thirds also experienced disrupted sleep after contracting the virus.

They believe that addressing sleep disruption by reducing anxiety and improving muscle strength in these patients could alleviate their shortness of breath.