Treatment Options for Tennis Elbow

Tennis elbow, also known as lateral epicondylitis, is a common condition that causes pain and discomfort on the outer part of the elbow. It typically results from repetitive motion or overuse of the forearm muscles. This leads to irritation or inflammation of the tendons connecting the forearm muscles to the lateral epicondyle (the bony prominence on the outside of the elbow). While it is often associated with playing tennis, this condition can affect anyone who performs repetitive arm motions, such as painters, carpenters, or office workers.

If you are experiencing symptoms of tennis elbow, which may include pain, stiffness, or tenderness near the elbow, it’s important to seek effective treatment to alleviate the discomfort and promote healing. Below are several evidence-based treatment options commonly used to manage tennis elbow.

1. Rest and Activity Modification

The first step in managing tennis elbow is to reduce the strain on the affected arm. Resting the elbow and avoiding activities that aggravate the pain, such as heavy lifting or repetitive gripping motions, can help the body heal naturally. While complete rest isn't always necessary, minimizing aggravating activities and using supportive devices, like an elbow brace or strap, can prevent further strain on the tendon.

2. Physical Therapy

Physical therapy plays a crucial role in the rehabilitation of tennis elbow. A physiotherapist will guide you through exercises that aim to strengthen the muscles around the elbow, improve flexibility, and promote proper movement mechanics. These exercises are designed to reduce stress on the affected tendon and gradually restore function. Stretching and strengthening routines are individualized based on the severity of the condition and may include:

• Flexibility exercises: Stretching the forearm muscles can help alleviate tension and reduce the strain on the elbow.
• Eccentric exercises: These exercises focus on lengthening the tendon while it is under tension, which has been shown to reduce pain and improve tendon health.
• Strengthening exercises: These exercises target the muscles of the forearm and elbow to improve endurance and prevent further injury.

3. Over-The-Counter Medications

For individuals experiencing significant pain and inflammation, over-the-counter NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), such as Advil, may be recommended to reduce swelling and provide temporary pain relief. While NSAIDs can help manage symptoms, they should not be used as a long-term solution. It’s always best to consult with a healthcare provider before taking any medication to ensure it's safe and appropriate for your condition.

4. Corticosteroid Injections

For more severe cases of tennis elbow that do not respond to conservative treatment, corticosteroid injections may be considered. These injections help reduce inflammation and provide temporary pain relief. While corticosteroids can be effective in the short term, they should be used cautiously, as repeated use may weaken the tendon and increase the risk of further injury.

5. Shockwave Therapy

Shockwave therapy is a non-invasive treatment that involves the application of high-energy sound waves to the affected area. This treatment has been shown to promote healing by stimulating blood flow to the tendon, breaking down scar tissue, and encouraging tissue regeneration. Shockwave therapy may be used when other treatments, like physical therapy or activity modification, have not provided sufficient relief.

6. Surgery

In rare cases, when conservative treatments fail to provide relief and the pain is persistent for over a year, surgical intervention may be necessary. Surgery typically involves removing the damaged tissue and reattaching the healthy tendon to the bone. However, surgery is usually considered a last resort after other treatments have been exhausted.

Conclusion

While tennis elbow can be a frustrating and painful condition, several treatment options are available to help manage symptoms and promote healing. A combination of rest, physical therapy, and conservative treatments can effectively alleviate pain and restore function. In more severe cases, interventions like corticosteroid injections, shockwave therapy, or surgery may be considered.

If you are experiencing symptoms of tennis elbow, it’s essential to consult with a healthcare professional, such as a physiotherapist or a doctor, to determine the most appropriate treatment plan for your specific condition. By addressing the issue early and using the correct treatment options, tennis elbow can be managed effectively, helping you get back to your daily routines and physical activities.

Written by Lauren Brigham, Master's of Physiotherapy Student, in collaboration with River East Physiotherapy 

References:

Bonczar, M., et al. "Lateral Epicondylitis: The Condition and Current Management Strategies." Journal of Orthopaedic Surgery and Research, vol. 17, no. 1, 2022, pp. 1-12.