Got pain in your funny bone? There’s nothing ‘humerus’ about elbow pain – otherwise known as ‘epicondylitis’ or tennis elbow. But here is something to put a smile on your face: research shows acupuncture can be helpful in easing epicondylitis.
What exactly is tennis elbow?
Epicondylitis is commonly referred to as tennis elbow, golfer’s elbow, or – my new favourite – mouse elbow (relating to computer mice, not Mickey). Considered an ‘overuse condition’, epicondylitis causes pain in either the inner or outer part of the elbow.
What are the causes of tennis elbow?
Tennis elbow (or epicondylitis) is caused by repeated contraction of the forearm causing tiny tears in the tendon that attaches to the elbow. Some activities that commonly cause this condition are:
- Racket sports – including golf and cricket
- Throwing sports – including archery and javelin
- Weight training – lifting weights using improper technique, that can overload the elbow muscles and tendons
- Repetitive occupational movements – including excess use of a computer mouse
- Using plumbing tools
- Driving screws
- Cutting up cooking ingredients
What are the symptoms of tennis elbow?
The main symptom is a pain in the elbow, one that may radiate from the outside or inner side of your elbow into your forearm and wrist. There can also be:
- Pain and tenderness – Pain typically worsens with certain movements.
- Stiffness – Your elbow may feel stiff and making a fist might hurt.
- Weakness – You may have weakness in your hands and wrists making it difficult to shake hands, grip objects or turn a doorknob.
- Numbness or tingling – These sensations might radiate into one or more fingers, usually the ring and little fingers.
How is tennis elbow diagnosed?
In most cases it is diagnosed by the presenting symptoms, simple orthopaedic tests and pressing in specific areas to reproduce pain usually associated with epicondylitis. In some cases, further investigation such as X-ray or ultrasound may be used to rule out any other conditions. These tests are not usually necessary to make a diagnosis.
Is tennis elbow difficult to treat?
The problem is that we need to use our arms in everyday life. We can’t just stop cooking or using a mouse for work or school. We can’t stop playing professional sports when that is our livelihood.
What adds to this is that there is disagreement about what is actually happening to the muscle to cause the tearing. Is the muscle tight or is the muscle weak? This will greatly change the focus of the treatment. One will focus on stretching and the other more on strengthening.
How can tennis elbow be treated?
Rest is the first step in your recovery. Why? To avoid the causative action as much as possible. At least two weeks rest is usually recommended. Your doctor may give you a brace to help immobilise the affected muscles to assist in this resting process. Other treatment approaches include:
- Ice (first 24hrs)
- Nonsteroidal anti-inflammatory medicines
- Physical therapy
- Ultrasound therapy
- Steroid injections
- Platelet-rich plasma injection
- elbow strap or tapping (specific for elbow pain)
- Exercises (flex bar)
- Massage therapy
- Diet therapy
The key to effective treatment is to provide the right amount of gentle stretching, muscle strengthening, reduce inflammation and pain, and improve function.
How can Evolve Natural Medicine help?
- Nutritional supplementation
Certain supplements can be useful for reducing general inflammation of the body and assist in pain relief – such as: fish oils, boswellia, and turmeric.
- Chinese Medicine
The use of Chinese herbs has been around for centuries and has treat pain and inflammation. Recent studies1 have been able to isolate the mechanisms by which this occurs. These mechanisms include reduction of pro-inflammatory pathways or cytokines, Cox-2 inhibition and antimicrobial effect.
A recent systematic review2 of randomised controlled trials of acupuncture and moxibustion for lateral elbow pain showed potential positive effect in the treatment of epicondylitis. Acupuncture also has a strong anti-inflammatory effect and as such can further assist with pain relief.3 A random control trial carried out by the Department of Physical Medicine and Rehabilitation at the Hannover Medical School (Germany) found evidence of potential positive effects in reducing pain and improving the functioning of the arm associated with chronic epicondylopathia lateralis humeri. A comparative study4 out of China found that acupuncture and TCM massage are effective in treating lateral epicondylitis for athletes and that combining the therapies increases positive patient outcomes.
A more recent understanding of the gut has shown that poor gut function can significantly increase levels of inflammation and pain in the body. As a result, looking at diet and dietary habits may assist to reduce overall inflammation and therefore provide pain relief in issues such as plantar fasciitis.
Author: Adrian Taricani
Registered acupuncturist, Evolve Natural Medicine
More about Adrian
M: 0491 738 260
- Rekik A. Muluye, Yuhong Bian, Paulos N. Alemu. Anti-inflammatory and Antimicrobial Effects of Heat-Clearing Chinese Herbs: A Current Review, Journal of Traditional Complementary Medicine 2014 Apr-Jun; 4(2): 93–98.
- 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 SP1.
- Acupuncture in chronic epicondylitis: a randomized controlled trial. Fink M1, Wolkenstein E, Karst M, Gehrke A.
- Qiu, Yanchun. “Comparative Study on the Treatment of Acupuncture and Massage of External Humeral Epicondylitis for Athletes.” Journal of Guangzhou Physical Education Institute 34.1 (2014): 100-102.