How to Eliminate Pain from Tennis Elbow

Lateral epicondylitis, or tennis elbow, is a condition or disease commonly found on the elbows of tennis players, but that also arises in everyday life (in fact, most people who suffer from epicondylitis have never played tennis.) It is a painful inflammation of the tendons of the extensor muscles of the hand, and pain is felt on the outer side of the elbow when there is muscular activity or when pressure is placed on the affected area. According to the severity, the pain spreads to the hand or the shoulder. If this condition is not treated properly, it can lead to serious mobility problems for the elbow.

 

This condition is considered a form of mechanical degeneration of the tendon that most often occurs in people over 30 years of age.

Tennis elbow for the most part arises from repetitive (and excessive) gripping or squeezing, or a direct blow to the area. It also appears after slight tears occur in the tendons or there is trauma to the elbow.

 

Among the common causes of this condition are: daily work on the computer, carpentry, masonry, and sports using the arm (e.g. tennis).

 

In tennis, this condition is caused by poor backhand technique. The pain is located in the lateral area of the elbow at the point of insertion of the epicondylar muscles that attach (i.e., adhere to the bone) on the lateral epicondyle, located on the side and bottom of the humerus bone. These muscles are responsible for wrist extension, so this move usually worsens the pain, as does direct pressure on the epicondyle.

 

Also, the pain is due to passive flexing, that is, when the epicondyle is bent and extensor muscles are stretched in the rear part of the arm. Usually this causes tendonitis, a product of supination (palm of the hand facing up) and pronation (palm facing down), and the continuous extension of the arm which pulls at the insertion point of these muscles and produces small lesions as tears.

 

However, there may be other causes of lateral epicondylitis from an articular or neural origin if there is a compression of the posterior branch of the radial nerve all the way from the back of the forearm or neck region. The most common is the ligament that was previously described.

The main symptom of lateral epicondylitis is pain in the affected area, which may extend to the wrist or shoulder, inflammation in the affected area, and lack of strength in the forearm.

 

Increasingly, there will be pain while resting the arm, loss of reflex and morning stiffness. Examples of actions that can trigger pain include using a screwdriver, hammering, using scissors, and all activities that require either grasping objects with your fingers or forearm rotations, even small ones.

 

Direct movement of the epicondyle causes a sharp pain and a dull ache at the back of the arm area. Laboratory tests or images are not necessary for diagnosis, which is yielded by a simple physical exam: painful supine with the arm extended, the hand closed and resistance to the epicondyle. Then the resistance is applied to the hand.

In most cases, non-surgical treatments are used. Proactively, the following are suggested:

 

- Reduce the activities that cause pain

- Modify activities that aggravate the pain

- Frequently rest and stretch the area

- Use an elastic elbow brace

 

More conservatively, there are:

 

- Reduction of joint movement

- Ice the elbow for 20 minutes every 3 or 4 hours for two to three days.

- Rubber band, which is placed around the forearm below the elbow to limit movement and therefore avoid pain.

- Thermotherapy with short-wave ultrasound

- Analgesic low and medium frequency current (e.g., TENS [Transcutaneous Electrical Nerve Stimulation], interferential, diadynamic, etc.), which is excellent for golfers, tennis players and all those practicing sports or activities that produce epicondelitis

- Other products include lavatherm cold packs, bio beam lights, acupressure, hand and foot exercise, Powerball, Theratherm compresses, and paraffin

- Massages

- Use of NSAIDs (Nonsteroidal anti-inflammatory drugs) such as ibuprofen or aspirin.

- Strengthening of the muscles is recommended

 

In the last decade, successful arthroscopic surgical techniques have been developed that produce no further complications.

 

If the origin of the condition is neural, created by compression of the radial nerve (in the posterior limb) and applying ice is not effective, physiotherapy and sometimes surgery will be needed. It is very important to consult a doctor after the first symptoms of discomfort or pain because depending on the origin of the condition, a different type of treatment may be needed to be successful.