Did you know that according to Medscape “tennis elbow” is more common in non-tennis players. Typically it affects people greater than 40 years old, with smokers being at a higher risk.
Tennis elbow is also known as lateral epicondylitis, which means an inflammation of the outside part of the elbow, but actually studies are showing that it is not an inflammation of the tendon but rather a degeneration. It occurs after repetitive extension of the wrist, with the backhand stroke of a tennis player being the most common athletic cause of this condition. Non-tennis causes of this condition include carpenters, bricklayers, seamstresses and tailors, politicians (excessive handshaking), and musicians (pianists and drummers).
The most common symptoms of tennis elbow are pain on the outside part of the elbow that is aggravated with activity and relieved with rest. The pain can radiate down the forearm, and can be mild (just with activities), or severe meaning pain with simple activities such as holding a coffee cup. I have had patients tell me that they decided to get treatment after they dropped a coffee cup due to weakness and pain.
Current medical treatment is anti-inflammatories and physical therapy. Studies show that the cortisone injection gives the fastest relief of pain in comparison to physical therapy and doing nothing, but that a year later they are usually worse. So with that happy news let’s look at what you can do treat this problem yourself.
1. Temperature therapies, good old ice and heat are great ways for you to treat this problem. Ice is a great pain reliever, so after activity when your elbow hurts the most, 10 minutes of ice on the area where it hurts is easy, cheap and effective. Since there is tendon degeneration, increasing the blood flow will help the tendon to heal and this is where moist heat comes in. Moist heat such as a hot bath, shower, or moist heat pack will penetrate deeper into the tissue to give you therapeutic benefit of increased blood flow. Dry electrical heat pads, and topical analgesics that give you a hot sensation on your skin do not increase the blood flow to the tendon which is what you need to heal.
2. This is going to sound silly but stop doing the activity that is causing your pain. Sometimes that is not possible if it is your job. Often patients tell me it is difficult to determine what the offending activity is, but after careful questioning we can usually figure out what is causing you to use your wrist in an up and down motion.
3. Stretching; repetitive movements often cause the muscles to tighten, which can aggravate the condition. Stretching will not only loosen the muscle to reduce the tension on the ligament but it will increase the blood flow to help the tendon to heal. An easy stretch is to straighten the elbow with your arm in front of you, and pull gently on the hand so that it bends at the wrist, and do both directions but pulling on the back of the hand will provide the best stretch.
4. When the pain has decreased and you can stretch without pain, very gentle exercises can speed up the healing process. I will have patients start by simply moving their wrist back and forth without weight 15 times. If they can do that without pain then I slowly add weight.
5. If the above suggestions do not work then let me suggest Chiropractic. There are several treatments we use to treat this problem. In my office we use instrument assisted soft tissue mobilization, which is a gentle stroking of the area with special tools to increase the blood flow, infrared light is used to increase blood flow and speed healing, and kinesio taping for support and faster healing in between treatments. Since your brain controls and coordinates the healing process we will also check the neck to make sure that the nerves coming to the elbow are not being pinched. Most are surprised to learn that nerves can be pinched without pain in the neck. This often provides the best long term relief when other treatments have failed.
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