If you have pain on the outside of your elbow and your forearm hurts when you grip or bend your wrist up, you might have tennis elbow.
Tennis elbow or “lateral epicondylitis” is one of the most common and vexing problems around the elbow. It often afflicts the active person in middle age, the laborer and the weekend warrior. If you are one of these people, nagging elbow pain is the last thing you want slowing you down.
The good news is you can successfully treat it more than 95% of the time without surgery.
But I Don’t Play Tennis? How Did I Get Tennis Elbow?
Lateral epicondylitis is a painful condition of the tendons that attach to the bony bump on the outside of the elbow. It is a bit of a misnomer. The suffix “itis” means “inflammation.” And while the elbow gets inflamed in the early phase of the disorder, tennis elbow is a condition caused by “degenerative” tendons.
The word “degenerative” is used a lot in medicine, so let’s clarify it for this condition.
As tendons age and wear they can undergo changes that make them less resilient. The cellular structure of the tissue changes. Like a rubber bands that dry over time, tendons lose some elasticity. Degeneration can also occur from micro tearing of the tendon. This micro tearing can produce alterations in the tendon that make it less more painful.
Degeneration occurs for various reasons including age and overuse.
One reason that injections alone often fail to cure tennis elbow is that they do not address the degenerative nature of the tendon tissue that is the underlying problem. To address this you need exercise or surgery. Since injections are typically anti inflammatory in nature, they only address the acute inflammation.
The other reason injections often fail to cure tennis elbow in the long run is behavioral.
There are some simple but effective exercises that can cure tennis elbow for good in most cases. But there’s a catch: you have to do the exercises a little bit everyday- sometimes for life- if you want to be certain that the condition won’t come back.
If I inject your elbow and you feel better, you are probably less likely to be motivated to do a long physical therapy program to ultimately treat your problem. This is a subtle but important point in practice.
Therefore, injections alone are never the treatment for tennis elbow in my practice.
The exercises that work best in my practice are called eccentric strengthening exercises. They can easily be performed at home with minimal equipment and often provide excellent and risk free pain relief. The problem is, you have to do them. Just like walking your dog or brushing your teeth, doing them once won’t work.
If all else fails surgery is an option. It’s a relatively straightforward surgery, but it’s not very common because most people get better without it.
If you think that you might have tennis elbow and you are looking to cure it long term, please contact us for a personal consultation.