Tennis Elbow: Early Treatment is Vital
There are plenty of things you can do to alleviate the pain caused by tennis elbow, says physiotherapist Jane Connolly HPC CSP
Tennis elbow – or lateral epicondylitis – is a common injury affecting the muscles or tendons of the forearm where they attach to the epicondyle of the humerus. It is classed as a tendinopathy which is aggravated by repetitive wrist extension or by gripping strongly whilst twisting your wrist.
Despite being called ‘tennis elbow’ it isn’t only racquet sports that causes the problems. Any job that involves a repetitious overuse of the wrist results in micro trauma within the tendons and may explain why, apart from the very early stages, the problem has been shown to be due to degenerative changes rather than an inflammatory process. Poor working positions on a computer over an extended period of time can also cause pain.
The most common symptom is pain and tenderness on the outside of the elbow or in the muscles of your forearm which comes on gradually over time or even a few days after the initial injury. The pain can vary from mild discomfort to severe pain that gets worse when trying to stabilise the wrist whilst gripping, like holding a cup, opening a jar, using a screw driver or shaking someone’s hand firmly. It’s also aggravated when you bend your wrist backwards against a force, for example when doing backhand in tennis.
Mild symptoms of tennis elbow ease with rest and most importantly by avoiding aggravating activities. There are some things you can do to help yourself. Lifting objects with your palm facing up, not down, will put less strain on your damaged muscles or using ice on your elbow can ease your pain for a while. For some wearing a strap, splint or brace around your forearm may help relieve the strain on your tendon meaning that you can continue with activities once the pain has settled down.
Physiotherapy is usually very effective in reducing pain and maintaining and improving movement and mobility. There are various techniques to reduce pain including deep tissue massage, ultrasound and laser therapy and most importantly exercises which are graded within the limits of pain to slowly increase muscle strength and length without causing damage.
Early treatment before the condition becomes chronic is most beneficial. Waiting too long can mean that the treatment choices become more invasive such as steroid joint injections, but often these ease pain initially but have limited success in the long term. As with every procedure, there are some risks linked with steroid joint injections. Other procedures offered are autologous blood injections which involve a sample of your blood being taken and injected back into your elbow or platelet-rich plasma injections which involves the plasma and platelets being injected.
Tennis elbow usually gets better using the treatments listed above. Early treatment intervention and rest, avoiding things that make it worse, is essential due to the degenerative nature of the condition. As a last resort you may be recommended to have surgery but often by this time the damage is done.