1.The Impact on Life
Lateral epicondylitis disrupts the ability to use the arm in almost any capacity, affecting the ability to perform routine tasks, including the ability to lift and hold items and perform various vocational tasks. The combination of the severely entrenched pain and the demand of classifying pain on an arbitrary scale lead to an overall degradation of quality of life, including the presence of psychological pain in addition to physical discomfort. In many cases is debilitating to athletes and active individuals. There is a well-documented recognized need and an urgent demand in the field of modern medicine to move beyond the less than acceptable current approaches of merely masking the symptoms of epicondylitis and Tennis Elbow. For many patients, seeking treatment at a Stem Cell Clinic is the most acceptable and the most clinically effective option. Along with many healthcare professionals and providers, patients cite the restoration of full biomechanical function as the most desirable outcome and priority.
2.Pathophysiological Mechanisms
Tennis Elbow begins with the development of multiple microtears in the extensor carpi radialis brevis tendon. With repeated mechanical stress, the natural regenerative process of the body is outpaced. The fibroblasts that are working to heal the tendon by synthesizing type I collagen are failing to do so. The tendon heals with disorganized and ineffective type III collagen that is structurally inferior. This incomplete healing is the start of angiofibroblastic tendinosis. The process of angiogenesis occurs but with the formation of weak, disorganized and ineffective blood vessels. There is a notable absence of inflammatory cells in the chronic stages, which is dominated by profound degenerative changes of the tendon. The extracellular matrix becomes severely hypoxic. The combination of pain and mechanical weakness is attributed to the release of nociceptive substances such as glutamate. This understanding of the pathophysiology creates the demand for a well-respected Stem Cell Clinic.
3. Current Traditional Treatments
The first line of conservative management consists of a combination of rest, ice, and the use of NSAIDs, along with the option of physical therapy. Of the many interventions utilized, the intra-articular or peri-tendinous injection of corticosteroids is the most popular. Surgical debridement is undertaken in the more refractory cases. Unfortunately, based on the nature of these traditional approaches, several impediments exist. Rest, for example, is the most ineffective of the approaches. As for the anti-inflammatory treatments, they fail to resolve the tendinopathy. Corticosteroid injections reduce pain but also inhibit collagen synthesis for a long time. The risk/benefit ratio, based on the repeated use of corticosteroids, favors rupture of the tendon. As for the physical therapy, a significant commitment on behalf of the patient is required and still does not guarantee the resolution of the pathology. Finally, the traditional approaches provide only temporary improvements and do not reverse the degenerative process of Tennis Elbow. Because of all these barriers, patients seek to go to a more advanced Stem Cell Clinic that provides the option of regenerative therapies to resolve the pathology.
4. Mechanisms Involved in Biological Treatments
As for the treatment of advanced Tennis Elbow, regenerative medicine has provided an impressive new alternative. One of the most advanced options at a Stem Cell Clinic involves the use of mesenchymal stromal cells. These cells exert a significant array of bioregulatory, paracrine, and reconstructive influences. Specifically, the injection of these cells into the injured extensor carpi radialis brevis tendon induces a significant biological repair process. In addition, the biologic matrix that is injected possesses a highly active array of growth factors as well as signaling molecules, specifically vascular endothelial growth factor and transforming growth factor beta. The therapy seeks to induce more normal angiogenesis by replacing abnormal blood vessels with an appropriate network. The rapid proliferation of fibroblasts ensures that type I collagen is produced instead of the less desirable type III collagen. A specialized Stem Cell Clinic focuses on the use of ultrasound to inject biologics into the anechoic spaces of the degenerated tendon. This placement of biologics provides the best opportunity for fibroblasts to populate the area. This therapy is unique in that it reconstructs the biological architecture of the tissue, making it a great option for the treatment of Tennis Elbow.
Figure 1: Current Traditional Treatments and Regenerative approaches in Tennis Elbow
The goal of new treatments at a Stem Cell Clinic in Thailand
The medical tourism industry is shifting toward Southeast Asia, and choosing a Stem Cell Clinic in Thailand is no exception to this trend. It is due to their relative affordability when compared to clinics in the West. Thailand has a state-of-the-art biotechnological infrastructure and has a rapidly supportive healthcare policy focused on biotechnological innovations. Many of the researchers in these clinics are the first to develop protocols for rehabilitating Tennis Elbow. Many of the clinics are internationally accredited, ensuring the safety of the patients. Because of Thailand’s healthcare policies, services that combine advanced Biologics with superior medical hospitality are the future of this country. This is especially true for patients suffering from chronic Tennis Elbow, as they are the ones most likely to travel to Thailand for personal treatment. Traditional treatments for Tennis Elbow focus on temporary relief, whereas the goal of new treatments at a Stem Cell Clinic is to provide complete and total rehabilitation.