Conditions > Tennis Elbow
Tennis Elbow Pain Relief
- Most tennis elbow pain does resolve on its own with proper rest. But you probably need more rest than you think.
- Tennis players, golfers, gardeners, construction workers, computer users, and weight lifters can develop tennis elbow by repeatedly straining muscles in the forearm past the point of exhaustion.
- Icing and anti-inflammatory medications (Advil) can help with short-term pain relief. Prolotherapy and PRP injections can accelerate healing process.
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What is Tennis Elbow?
Pain on the outside of the elbow is commonly referred to as “tennis elbow” or sometimes as “golfer’s elbow” (lateral epicondylitis). Tennis elbow is a repetitive strain injury that comes from a strain of the tendons and muscles surrounding the elbow joint.
Most sufferers of tennis elbow or golfer’s elbow used to be tennis players and golfers, but today anyone who frequently works with the hands, gripping objects can develop lateral elbow pain. Some common sufferers of tennis elbow include:
- Tennis players
- Construction workers
- Heavy computer users
- Weight lifters
What causes tennis elbow?
Tennis elbow is classified as a form of tendinopathy, which describes a general dis-ease of a tendon. This means the tendon is tender and experiences pain, particularly when exercising or with movement.
Tennis elbow develops when muscles and tendons in your forearm are repeatedly irritated. Typically, gripping something with your hands and flexing the wrist can result in these irritated tendons.
As muscles become exhausted and stressed, they begin to pull at the insertion to the bone. As these muscles pull over and over again, inflammation and micro tearing can occur. In worst cases, this can lead to chronic inflammation of the elbow joint.
Muscle pain is also an important but often overlooked pain factor in tennis elbow. Trigger points and sore muscles can be responsible for the majority of your elbow pain.
The good news is in most cases, tennis elbow is at worst an annoyance. Few people experience chronic elbow pain.
Tennis elbow symptoms
Symptoms of tennis elbow can help determine if the pain is being caused mainly by tendon strain or by muscle pain. In either case, the condition is painful and uncomfortable. The most common symptom is pain:
- Pain on outside of the elbow
- Pain on inside of the elbow (golfer’s elbow)
- Pain along the back of the elbow (muscle pain)
- Pain when lifting an object
- Pain when making a fist or gripping
If you feel a burning or sharp pain on the outside of the elbow, you are likely suffering from elbow pain caused by tendon strain. The pain can get worst when gripping something or with bending of the wrist.
If you feel a dull ache all around the elbow, not just on the outside, but also in the back of the elbow, muscle pain may be responsible. Muscle pain occurs when ligaments are weakened due to tearing or damage, and the muscle strain to hold the joint together.
Tennis elbow treatments
Acute vs Chronic Elbow Pain
Most tennis elbow pain does resolve on its own with proper rest. Rest, as with all repetitive strain injuries, is the best remedy. If you’re suffering from tennis elbow, realize you probably need more rest than you think.
- Acute elbow pain relief – Acute elbow pain refers to a non-chronic form of pain. Basically, the pain your experience has not been ongoing for months or years. Acute elbow pain resolves on its own within weeks or months.
To control symptoms of pain and inflammation, icing, anti-inflammatory medications like Advil, and at times steroid injections can be used.
- Chronic elbow pain relief – For chronic cases of elbow pain, the bones of the elbow and the wrist must be stabilized to prevent further irritation and micro tearing of the muscles and tendons. Regenerative treatments like prolotherapy and PRP can be used to increase blood flow to the elbow. Why is this important?
By design, tendons and muscles don’t have the best blood flow, and blood is what’s needed to repair damaged tissue. By stimulating the area with regenerative injections, the body is naturally stimulated to repair damaged tissues and stimulate new tissue growth.
Prolotherapy for tennis elbow
Prolotherapy is an injection technique. Dextrose, a sugar solution, or platelet rich plasma (PRP), a solution that uses your own blood, is injected into the weakened or damaged tissues in the elbow. This activates your body’s natural immune response, which starts the breakdown of those tissues, and stimulates tissue repair. In cases of tennis elbow, prolotherapy is used to accelerate healing, or to restart healing in chronic cases.
Osteopathic manipulation for tennis elbow
Osteopathic manipulation or manual manipulation can assist in relieving both acute and chronic tennis elbow pain by ensuring alignment of the elbow is not straining muscles and tendons.
In some cases, trigger points can develop in muscles surrounding the elbow. Manual manipulation treatments can break up these painful muscle knots.
Inserting acupuncture needles into the arm can help reduce pain and inflammation in the elbow. Acupuncture has been shown to help increase blood flow, help calm down frayed nerves, and stimulate the release of the body’s own natural painkillers, all of which can help with healing tennis elbow and, perhaps more importantly, make any pain more bearable.
Home remedies for tennis elbow
Rest, rest, and more rest – Rest is the best way to relieve elbow pain. Remember, tennis elbow is a repetitive strain injury that’s led to inflammation and micro tearing of the tissues surrounding the elbow joint. The longer you can rest the elbow when the injury first occurs, the easier it will be to rest those tissues.
Icing massage – Icing for tennis elbow can help reduce pain and inflammation. An easy way to reduce elbow pain is to massage it with an ice pack. You will want to massage the ice directly over the painful part of the elbow for several minutes (don’t let the skin come into direct contact with the ice). At the beginning of the injury, these types of ice massages can help.
Tennis elbow brace – An elbow brace can help stabilize tendons and muscles in the elbow to allow healing and rest. If you work a physical job, I recommend investing in an elbow brace. Don’t let the relief from an elbow brace fool you! Remember that returning to normal activities before the elbow is completely healed can result in chronic elbow pain. Use the elbow brace, but remember that it does not affect how long you need to rest the elbow.
Tennis elbow stretches and exercises – You will want to gently incorporate stretching to help mobilize the muscles. Instead of static stretching, where you basically hold the muscle in a stretch, I recommend you do “active stretching”. Active stretching for tennis elbow can include:
- Extended wrist flexing – Rest the injured forearm on a flat surface with your palm facing upwards. As you extend your wrist upwards, carefully open and close your palm. Do this up to 10 times, and repeat throughout the day.
- Mobilizing stretch – Place your palm on a flat surface and gently point the fingers of the hand towards your body. This should twist your arm and flex your wrist. Gently lean on the arm to add pressure to the stretch, and then release. Repeat this pressure on and off motion up to 10 times.
- Elbow drop – If you are unable to straighten the elbow, a simple stretch you can do is bring the fist of your injured arm up to your chin with the palm facing towards you, as if you were curling a weight, and let your arm drop to mobilize the elbow.
Self-massage – If you don’t have access to osteopathic manipulation treatments, the elbow is a very easy place to self-massage. If your elbow pain is coming from muscle pain or trigger points, do a cross fiber massage. By massaging the muscles on the outside of the elbow, you can help the healing process of the micro tears often found in ligamentous injuries.
To do a cross fiber massage, run your fingers up and down across, or perpendicular to the muscle. Do this for as long as you can bear it, up to 5 minutes, and repeat every day.
A comment on using anti-inflammatory medication
Remember, we don’t want to suppress inflammation. Inflammation is how our body heals when it’s injured. So we do need some inflammation. In cases of repetitive stress injuries that aren’t properly rested, too much inflammation can occur. This is not productive anymore.
Think of it like a little fire that smolders. The fire is not big enough to do anything worthwhile, but it is still hot and burning. We need the right kind of inflammation in the right place so the body can heal.
If you’re suffering from lateral elbow pain, treat the area yourself by resting the area. For short-term pain relief, ice and over the counter anti-inflammatory medicine can help. Steroid injections are also a common option.
All of these, however, reduce the inflammation and don’t heal the structures in the arm that led to the development of lateral epicondylitis. To heal the structure takes time and rest.
The healing process can be accelerated by with prolotherapy and platelet rich plasma (PRP) injections, acupuncture, and osteopathic manipulation. Good luck!