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Applying heat and ice in combination works extremely well, as ice controls swelling and heat heals and promotes blood flow and also relieves the tightness and pain.
Although not founded in clinical research , the tennis player's treatment of choice is frequent icing and compression (Cold compression therapy) for inflammation, and taking anti-inflammatory pain-killers, such as ibuprofen. In general the evidence base for intervention measures is poor.[3] A brace might also be recommended by a doctor to reduce the range of movement in the elbow and thus reduce the use and pain. Also, ergonomic considerations are important to help with the successful relief of lateral elbow pain.
Initial measures
Rest, ice and compression are the treatments of choice. There are many excellent cold compression therapy products available. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce pain, and inflammation.
Exercises and stretches
Stretches and strengthening exercises are essential to prevent re-irritation of the tendon. Progressive strengthening for this condition involves using weights or elastic theraband to increase wrist flexion strength (grip strength). Racquet sport players also are commonly advised to strengthen their shoulder rotator cuff and scapula muscles to reduce any overcompensation in the wrist flexors in gross arm movements (such as a swing).
Physiotherapy
With physiotherapy, ultrasound can be used to reduce the inflammation and promote collagen production although the current evidence for its efficacy is inconclusive. Manual therapy (a form of physiotherapy) is an important part of the treatment; and can take the form of elbow joint mobilisations/manipulations and/or extensor muscle tissue mobilisations. Nerve mobilisation can also be helpful if the Physiotherapist finds a positive nerve tension test in their assessment. The most common upper limb nerve found to be sensitive is the radial nerve for this condition. Elbow clasps are also found to give temporary relief of symptoms.
Local steroid injections
Intra-articular glucocorticoid steroid injections can resolve episodes for several months, but there is a risk of later recurrence. Following an injection, the patient normally experiences increased pain over the subsequent day before the steroid starts to settle the condition over the next few days . As with any steroid injection, there is a small risk of local infection and tendon rupture. Most doctors will restrict after two injections giving further courses, as there is less likelihood of effectiveness but increased risk of side-effects.
As opposed to short-term effects , the longterm benefits of local steroid injection are less clearly established.
Surgical intervention
If conservative measures fail, release of the common extensor origin may be helpful.
Indications for operation:
Tennis elbow (lateral epicondylitis) which has not responded to conservative treatment .
Anaesthetic:
General Anaesthetic (Fully asleep) or regional (the arm will be numb) Local anaesthetic will be injected into the wound for post-operative pain relief
Operation type:
Open
Incisions:
A 3cm incision over the lateral epicondyle (the tender area).
Procedure:
The common extensor origin is released from the lateral epicondyle and scar tissue removed.
Wound Closure:
A single non-absorbable suture running under the skin will be used to close the wound, paper stitches will be placed over this.
Dressings:
An Elastoplast dressing will be placed over the top of the paper stitches and an elastic support bandage over the top of this.
Immediate aftercare:
You can go home when you feel comfortable.
Alternative treatments
Laser Therapy
The Use of Laser Therapy (Low Power or Low Intensity Laser Therapy) is a currently used treatment. The approach was spun off of research on how light affects cells. The findings, that light stimulates and accelerates normal healing, sparked the creation of several devices. The dosage often determines the extent of the success with this treatment, so it is generally recommended that experienced clinicians apply the therapy with a device that can be 'customized.' Professional athletes have used the therapy, and it has gained attention in the media lately, on shows like the Canadian health program "Balance" on CTV.
Acupuncture has been proven to be beneficial.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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