Paula, a Bikram yogi walked in for class the other day and asked me how my elbow was going. She had read my blog and was curious why I chose a cortisone injection rather than an autologous blood injection. Say what? She quickly explained there was an alternative to cortisone injections. This was news to me so I thought I’d do some research.
What is Cortisone?
Most people have heard of Cortisone. In its natural form it is one of the main hormones released by the adrenal gland in response to stress. In chemical structure, it is a corticosteroid. Corticosteroids may be administered in a number of ways but in this post I’ll be keeping it simple. For instance, I received a cortisone injection for tendonitis in my right elbow. I was in quite a lot of discomfort especially as I kept banging it on everything I walked past and no amount of anti-inflammatories could rein it in. My local GP referred me to a radiology clinic where I received an ultrasound-guided cortisone injection with the goal of reducing inflammation, thereby reducing pain. It definitely took the edge off the pain but I wouldn’t say I’m healed. Nor was I happy about injecting a foreign substance into my body in the first place.
What is an Autologous Blood injection (ABI)?
Autologous Blood (ABI) uses the growth factors and natural healing cells in your own blood to help repair tendon damage and treat the pain caused by injuries and chronic wear.
An Autologous Blood Injection (ABI) is a medical procedure whereby a patient’s blood is injected (ultrasound-guided) into an area of the body for the purposes of healing. It is most commonly used to treat degeneration of tendons frequently referred to as tendonitis.
Why Autologous Blood Injections may be the better option
Well it just makes sense! How cool is it that you can use your own blood to heal yourself? I’m not a doctor so to research for this post, I read a number of peer-reviewed trials (searched on Google Scholar) to assess the efficacy of Autologous Blood Injections. From what I read it comes down to the following:
1. tendonitis has been misdiagnosed as inflammation.
Lateral Epicondylitis is thought to be secondary to degeneration of the common extensor origin. It is now accepted that it is not an inflammatory condition but a fibroblastic and vascular response, pathologically known as angiofibroblastic degeneration although more commonly referred to as tendinosis. Treatments such as steroid injections have been focussed on a presumed inflammatory process that does not exist in tendinosis. While it is recognised that steroid injections may provide symptomatic relief, there is no evidence that steroids promote healing. .
2. Pain vs healing. While a corticosteroid may relieve short-term pain, autologous blood promotes healing.
With reports of tennis elbow being a degenerative process rather than an inflammatory one, the entire plethora of modalities aimed at arresting the inflammatory cascade seem ineffective. Nevertheless local injection of steroid has been proven to impart a consistent and predictable good short-term pain relief. Delivery of autologous blood derived growth factors to the site of disease has also been shown to significantly help the healing process in tennis elbow. .
Many of the trials I read have the same outcomes. It’s quite interesting that between groups, one receiving a steroid, the other autologous blood that group analysis at 2 weeks showed no difference in pain relief although evaluation at 6 weeks demonstrated a significant decrease in pain levels and stage of disease in the blood group.
Where can I get one?
The problem is, I don’t think ABI’s are really that common. Not yet anyway. The radiology clinic I was referred to does not perform them and I’m guessing this technique is still gaining traction. Dare I say, the makers of corticosteroids will be in a flip when it does. If, like me, your tendonitis is not healing with rest and yoga, consult your GP and be sure you get a referral to a clinic that performs both corticosteroid and ABI so you do have a choice.
I’m local to the Sunshine Coast, Australia and obviously shouldn’t recommend a radiology clinic but while I was researching I found a particularly straightforward explanation of ABI and the procedure at Dr Jones & Partners Medical Imaging.
If you have any experience in this area, please share your story.
 Ultrasound-guided autologous blood Injection for tennis elbow Click “look Inside” above the heading.
 Comparison of short term results of single injection of autologous blood and steroid injection in tennis elbow: a prospective study