Why do my elbow or heel stay sore?

What can calm my elbow or heel at home?

For elbow soreness, you might use a lighter grip and carry smaller bags for a while. Here’s one slow wrist exercise: rest your forearm on a table, hold a very light object, then lower your hand slowly. For heel soreness, comfortable shoes, shorter walks, and gentle calf raises may be easier to judge. You’ll want to begin with only a few easy repeats and notice how you feel the next morning. If walking or gripping gets harder each day, it’s time to arrange an exam.

There’s no prize for pushing through a sharp flare.

Could the PRP shot be worth asking about?

QC Kinetix offers consultations for soreness linked to tennis elbow or plantar fasciitis. Its regenerative treatments are non-surgical choices the clinic makes using blood from you. In some studies, a steroid shot eased tennis-elbow soreness sooner, while PRP had better pain and daily-use scores after six months. Heel studies also found more relief with PRP than steroid shots after three to six months, though the findings weren’t alike. That possible later gain may be worth discussing, but it isn’t certain for your elbow or heel.

The exam still has to come first.

Sources

1. A 12-centre randomized controlled trial of 230 patients with chronic lateral epicondylar tendinopathy compared tendon needling with leukocyte-enriched PRP against tendon needling alone. At 12 weeks there was no significant difference (55.1% versus 47.4% pain improvement; P=.163). At 24 weeks the PRP group reported 71.5% versus 56.1% pain improvement (P=.019), a 83.9% versus 68.3% success rate (P=.037), and significantly less residual elbow tenderness (29.1% versus 54.0%; P=.009). No significant complications occurred in either group.

   Mishra AK, Skrepnik NV, Edwards SG, et al. — Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. American Journal of Sports Medicine, 2014. DOI: 10.1177/0363546513494359.

2. A meta-analysis of 11 randomized trials (730 patients) with lateral epicondylitis found corticosteroid better than PRP in the short term (under 2 months) on VAS pain (MD 0.93; 95% CI 0.42-1.44) and DASH (MD 10.23; 95% CI 9.08-11.39), while PRP was better in the long term (6 months or more) on VAS (MD -2.18; 95% CI -3.13 to -1.22), DASH (MD -8.13) and Mayo Elbow Performance Score (MD 16.53). The two treatments trade places over time rather than one dominating.

   Xu Y, Li T, Wang L, et al. — Platelet-Rich Plasma Has Better Results for Long-term Functional Improvement and Pain Relief for Lateral Epicondylitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. American Journal of Sports Medicine, 2024. DOI: 10.1177/03635465231213087.

3. A meta-analysis of 20 trials (1268 participants) covering elbow epicondylitis and plantar fasciitis found that for epicondylitis PRP gave a statistically and clinically meaningful long-term improvement in pain versus corticosteroid, with a very large effect size of -1.3 (95% CI -1.9 to -0.7), but the evidence level was LOW; there was moderate evidence that corticosteroid gave better short-term (1-3 month) pain relief than PRP.

   Huang K, Giddins G, Wu LD — Platelet-Rich Plasma Versus Corticosteroid Injections in the Management of Elbow Epicondylitis and Plantar Fasciitis: An Updated Systematic Review and Meta-analysis. American Journal of Sports Medicine, 2020. DOI: 10.1177/0363546519888450.

4. A systematic review of 26 studies of PRP for lateral epicondylitis assessed against minimal clinically important difference thresholds rather than statistical significance found the mean improvement exceeded the MCID from week 4 through week 104 for VAS and DASH, and from weeks 4-52 for the Mayo score. Both leukocyte-rich and leukocyte-poor systems met the MCID at almost every observation point.

   Niemiec P, Szyluk K, Jarosz A, et al. — Effectiveness of Platelet-Rich Plasma for Lateral Epicondylitis: A Systematic Review and Meta-analysis Based on Achievement of Minimal Clinically Important Difference. Orthopaedic Journal of Sports Medicine, 2022. DOI: 10.1177/23259671221086920.

5. A systematic review and meta-analysis of nine randomized trials (239 PRP patients, 240 corticosteroid patients) in chronic plantar fasciitis found statistically significant differences in VAS pain favouring PRP at 1-1.5, 3, 6 and 12 months, and in AOFAS function favouring PRP at 6 and 12 months (no difference at 1 and 3 months).

   Hurley ET, Shimozono Y, Hannon CP, et al. — Platelet-Rich Plasma Versus Corticosteroids for Plantar Fasciitis: A Systematic Review of Randomized Controlled Trials. Orthopaedic Journal of Sports Medicine, 2020. DOI: 10.1177/2325967120915704.

6. A meta-analysis of 15 studies in plantar fasciitis found PRP superior to corticosteroid on AOFAS at 6 and 12 months (P=.009 both) and on VAS at 3, 6 and 12 months, with no advantage in the first month. The authors added the caveat that nine of the fifteen studies had a high risk of bias and that 'different protocols for PRP preparation reduce the internal and external validity of these findings' - the preparation problem stated as an explicit limit on the conclusion.

   Hohmann E, Tetsworth K, Glatt V — Platelet-Rich Plasma Versus Corticosteroids for the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis. American Journal of Sports Medicine, 2021. DOI: 10.1177/0363546520937293.

7. In a randomized comparative trial of chronic severe recalcitrant plantar fasciitis, the corticosteroid group's mean AOFAS score rose from 52 to 81 at three months but fell back to 58 at 12 months and 56 at 24 months, while the PRP group rose from 37 to 95 at three months and held at 92 at 24 months. The pattern - steroid relief that fades, PRP relief that persists - is the clearest single illustration of the durability difference.

   Monto RR — Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis. Foot & Ankle International, 2014. DOI: 10.1177/1071100713519778.