Q: My doctor says my elbow pain is due to tennis elbow. But I don’t play tennis. Could you explain how this has come about and what I can do about it?
A: “Tennis elbow” is a common term for a condition doctors call lateral epicondylitis. It’s caused by inflammation of the tendon that connects the extensor muscles of the wrist to the outside of the elbow.
Probably fewer than 10 percent of people get this by playing tennis. The usual causes are recreational activities such as gardening, job-related lifting, using a screwdriver or wrist overuse.
The medial epicondyle can also get inflamed. In this condition, called medial epicondylitis, the affected tendons connect the flexor muscles of the wrist to the inside of the elbow. It’s commonly called “golfer’s elbow” or “pitchers elbow.” Tightening and twisting the wrist from activities such as golfing or throwing a baseball can cause it.
Most people with medial or lateral epicondylitis feel pain when their doctor applies direct pressure to the inflamed area. He or she might ask you to push your wrist against resistance, which could also cause pain. You might also feel pain with handshaking, lifting a briefcase or heavy pot or similar activities.
The treatment is similar for both conditions.
LLLT Low Level Laser Therapy is widely used for any inflammatory condition. Given the minimal depth to the affected bone-tendon area, there is little to impede the efficacy of laser treatment.
rSWT Radial ShockWave Therapy was developed little over 10 years ago by the Swiss company that treats kidney and gallstones. It is the latest treatment for those myofascial trigger points; those areas of chronic, nagging pain, whether it be from overuse or poor postural habits, we all have them.
You could wear a wrist splint or forearm brace to prevent overuse of the muscles of the forearm.
You can also try a non-steroidal anti-inflammatory drug (NSAID such as ibuprofen or aspirin) and ice packs to help relieve symptoms. Your doctor may recommend physical therapy, especially if you need to return to a job or activity that caused the problem.
Sometimes doctors recommend one or two steroid shots over the affected epicondyle. But there is some risk of tissue loss around the elbow with repeated shots.
The symptoms of “tennis” or “golfer’s” elbow normally get better within a few months with conservative therapy. Once the symptoms disappear, you should begin gradual stretching and strengthening of the tendon and muscle attachments. We will develop an exercise program for you specific to your chosen activity or sport mechanics.
We will also look at your biomechanics. How you move, and perform your work is called ergonomics. Even the simplest changes can have great affects on chronic pain.
Call or email today, I can probably assess your elbow the next business day.
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