let me preface the following by pointing out that I am not a doctor!!! I'm simply relating my experience and knowledge accumulated from reading and discussions with my doctor. My tennis-elbow saga: Over the past 6 years I have battled persistent tennis elbow. My left elbow developed T.E. as a result of golf (probably too much hitting off of plastic mats!) and was chronic enough to require surgical repair (after countless cortisone shots, re-hab, etc.). Two years ago (as my left elbow was healing from surgery) I got back into tennis and almost immediately developed TE in my right elbow. After swithching to a heavier "players" racquet, having a pro check my form (no obvious problems discovered), perpetual icing-down, ibuprofen, alleve, and finally a cortisone shot, I still was not getting any relief and was fearful that I was heading for yet more surgery. Finally, my orthopedic surgeon (the one who fixed my left elbow!) referred me to a new physician in their practice (Bryn Mawr Orthopedic Associates) who was a very strong advocate of something called Prolotherapy. With my appointment 2 weeks away, I began reading as much as I could on the subject. It's a pretty interesting approach that challenges the time-honored "R.I.C.E." paradigm (stands for Rest, Ice, Compression, Elevation) as the appropriate treatment for tendon injuries. In short, the premise is that tendon and ligament injuries should NOT be treated the same way as muscle injuries are treated (i.e., with swelling-reducing intervention). Attempts to reduce swelling through R.I.C.E. and the taking of N.S.A.I.D.s (ibuprofen, Alleve, Aspirin) are increasingly viewed by many sports medicine docs as quite counterproductive in the case of tendon injuries. Whereas the swelling response of a muscle injury is generally so severe that that the swelling becomes problematic (hence the need for R.I.C.E.), tendons/ligaments swell very little. In fact, because of their very limited blood supply, the body's healing processes simply aren't adequately triggered. In essence, some swelling is good and necessary part of the healing process - while too much of it is a bad thing, so is too little. Tennis elbow (lateral epicondylitis) is a painful condition where small tendon tears persist without healing - it is believed by proponents of this treatment - because the body's own healing-processes are not adequately triggered. It is believed that TE occurs when elbow tendons become lax and some play develops in the joint which allows for destructive rubbing of bone against tendon within the joint. Prolotherapy is a process of injecting an irritant (glucose in my case) directly into the injured tendon with the goal of causing temporary swelling and triggering a more pronounced healing response from the body. Unlike cortisone which only reduces the pain temporarily (and allows the root cause to continue and perhaps worsen), Prolotherapy is intended to help heal the injury AND help prevent reoccurrence by leading to a tightening and thickening of the tendon/ligament. Apparently, it's not altogether new. It used to be the standard treatment for many soft-tissue injuries up until the 60's when cortisone became popular. If you go this route, your doctor will urge you to cease using all anti-inflammatories and ice! All I can say is that it definitely has made a difference in my case! I was skeptical, but it's clearly working. I've had two treatments (with 4wks b/w) and I'm now about 90% free of all pain. This is far better than what I was able to accomplish through icing, bracing, cortisone shots, etc.. Though the shots are quite painful, they are considered (even by those who are question the treatments effectiveness) to be quite safe and non-invasive. If you have persistent TE, I urge you to ask your doctor what he knows of prolotherapy. If he knows very little, then I urge you to call around to other Sports-medicine practices until you find some who can refer you to a practioner. You can also visit prolotherapy.co(m) to read up and find a listing of practicing physicians in your area.