Tennis Elbow Symptoms, Causes, Treatments, Cures
Pain in the Elbow – Treatment of One of the Common Sports Injuries
Oct 20, 2009
There are many potential causes of pain in the elbow. Tennis players are especially susceptible, but up to three per cent of the population will suffer at some time. Most at risk are those aged between 35 and 55.
In general, tennis elbow symptoms are annoying rather than serious, and go away after a few months. But the worst cases may persist for years, during which the sufferer may experience great discomfort even in lifting a cup, and be quite unable to do anything as demanding as wielding a tennis racquet or a hammer.
Tennis Elbow Symptoms
In a person standing up straight, arms by the sides and palms towards the body, the area affected is the front part of the outer elbow. The tennis backhand is one movement which can cause considerable pain, and some discomfort may be constant. The onset is almost always gradual, which means that elbow pain which appears suddenly is unlikely to be tennis elbow. The affected area will be tender to the touch, and pain will be felt upon gripping.
Causes of Pain in the Elbow
The discomfort results from the overuse of the arm, and develops when the tendon that joins the muscles of the forearm to the upper arm bone is damaged. Any activity which involves repeated movement of the hand, wrist and forearm may trigger tennis elbow symptoms. The name "tennis elbow" is somewhat misleading, because while incidence is especially high among those who regularly wield a racquet, most sufferers are not tennis players at all. The condition is also common amongst those, who, for example, make frequent use of a screwdriver or a pneumatic drill.
Treatment of Tennis Elbow: the Queensland Research
Over the years, many different therapies have been tried for tennis elbow. In 2006, Bill Vicenzino of the University of Queensland in Australia reported the outcome of some research into the efficacy of various treatments for tennis elbow. The researchers divided their subjects into three groups. One group was treated with corticosteroid injections, one was given physiotherapy, while the third received no treatment of any kind.
- At one time, the most common medical treatment of tennis elbow was by injecting into the painful spot a corticosteroid such as cortisone, which controls both inflammation and pain. In most instances, relief of the symptoms of tennis elbow is almost immediate, as was the case with the Queensland subjects.
- For the group which received physiotherapy, the elbow treatment was manipulation in which the physiotherapist applied pressure to the tender area in such a way as to enable the patient to perform the normally painful movements without discomfort. The benefit of such treatment comes from preventing the muscle system from weakening, as is inevitable if the sufferer, quite understandably, tries not to use the muscles involved in the painful activity at all.
- Because some movement is of great value in the recovery process, the third group in the Queensland experiment, the wait-and-see group, were told not to rest the troublesome limb completely, but to use it in such a way as to minimize pain. Aside from this advice, the wait-and-see group received no therapy.
Treatment of Tennis Elbow: the Queensland Findings
For up to six weeks, the corticosteroid injection group did best, but from then on were no better than the physiotherapy group, and by three months were in general worse. Lagging behind both after six weeks was the wait-and-see group. However, within three to six months, this group was doing as well as the physio group.
Corticosteroid injection, then, has the poorest long-term prognosis. Recent research suggests that while the tendon is certainly the cause of the discomfort, it is not inflamed. The injection, then, deadens the pain, but the anti-inflammatory effect is unlikely to be of value.
Implications for the Treatment of Tennis Elbow
If the sufferer really must use the painful arm for a few weeks – take, for example, a tennis player with a big tournament coming up – an injection may be worth considering. But even then, the longer-term outlook is poor.
To get better as quickly as possible without subsequent relapse, physiotherapy is a much better option. Certainly it is better than doing nothing – the worst thing of all would be to put the arm in a sling.
But those whose tennis elbow pain is tolerable, and who prefer not to go to the trouble of seeking therapy, may simply to go on using the affected limb in ways which do not cause too much discomfort. Within twelve months, and often much sooner, the pain will have gone away in up to 80% of cases.
For the small number of sufferers who do not respond to physiotherapy or to the wait-and-see approach, injections of some sort might be considered – corticosteroids are not the only option. Only in the most intransigent cases is surgery recommended.
Source:
Read, Malcolm. Sports Injuries: a unique guide to self-diagnosis and rehabilitation (3rd edition). Edinburgh, 2009
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