Tennis elbow, not funny.

Despite the name you don’t actually have to play tennis to get tennis elbow. You can get it from any repetitive activity that involves the specific muscle called the extensor carpi radialis brevis. Yeah that is one mouthful for a small muscle. The reason, when it wants to have attitude the pain can be unbearable and despite being in the region of your ‘funny bone’ it is definitely not funny. So what is it?

Tennis elbow otherwise known as epicondylitis is a type of tendonitis that affects said four word muscle above. Tendonitis is inflammation of the tendon and can be from microscopic tears of the tissue resulting in swelling and pain. The reason this happens is generally through overuse or specific trauma to the region.

What are the symptoms?

Pain, burning or aching along the outside of your forearm and elbow, which can gradually increase with time. Continued use or overuse while the tendon is inflamed will naturally result in the problem getting worse. Pain can begin to radiate down to the wrist and can be present even while resting. Pain can be felt even when trying to lift small objects and a decreased grip strength can be experienced.

What causes Tennis Elbow?

Essentially the inflammation is caused by overuse and specific actions such as gripping and fine repetitive hand movements that involve twisting the arm, using thumb and first two fingers and bending the elbow Things like playing a violin or holding a tablet for long periods. Yep time to reduce the scrolling folks. It may also be caused by trauma to the elbow.

Potential triggers may be job, hobby or sport related such as:

  • Carpentry
  • Plastering
  • Painting
  • Professional jar opening (lol), t
  • Typing
  • Computer gaming
  • Knitting
  • Racquet sports
  • Using hand tools repeatedly such as garden shears, scissors or screwdrivers
  • Weight training

How is Tennis Elbow diagnosed?

  • Physical examination and palpation
  • Range of motion tests
  • Strength tests
  • X-ray – checking the skeletal structure for things like arthritis
  • MRI – Helps to highlight inflammation and tendons damage
  • Electromyography (EMG) – to test for nerve conduction problems

How is epicondylitis treated conventionally?

The main approach is to reduce inflammation and activity to allow the area to heal effectively. Pain can be managed by:

  • Pain medication
  • Splints or strapping to support the affected area
  • Manual therapy to help reduce the tension in the forearm. The important thing with manual therapy is it is best that the pressure is not too strong as while it might reduce muscle tension it can aggravate the inflammation.
  • Steroid injections
  • Surgery to remove or repair tendon damage

What are some ways to manage Tennis Elbow?

The most important thing to do is to rest your injured arm and stop doing the activity that caused the problem.

  • Avoid or reduce repetitive movements that create the pain
  • Stretching and strengthening exercises
  • Use the right equipment for you if you play racket sports
  • Warm up before exercise

Can Acupuncture help?

 A review of 19 Randomised Control Trials (1) found acupuncture to be more effective than sham acupuncture in reducing pain and symptoms.

Another systematic review (2) found acupuncture to be effective in management of pain associated with epicondylitis and that in 6 trials it was more effective than the control group.

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References:

  1. Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials.Gadau M, Yeung WF, Liu H, Zaslawski C, Tan YS, Wang FC, Bangrazi S, Chung KF, Bian ZX, Zhang SP
  2. Acupuncture for the alleviation of lateral epicondyle pain: a systematic review  V. Trinh, S.-D. Phillips,  E. Ho,  K. Damsma