Editor’s note: House Calls runs every other Thursday. Today’s column is written by Bradley R. Kime, staff physical therapist at Sutter Coast Hospital.
Lateral epicondylosis, aka “tennis elbow,” is a condition where the outer part of the elbow becomes painful and may radiate into the forearm and wrist.
It is the tendon that attaches the wrist muscles to the outer part of the elbow that is affected. It is generally painful when a person shakes hands, holds a coffee cup or turns a doorknob.
First recognized in people playing racquet sports in the late 1800s, it was given the name “tennis elbow.” However, it commonly occurs in people who’ve never before played tennis. The majority of cases occur in people ages 31-50, and it equally affects both genders and generally occurs on the dominant side. The condition affects 3 percent of the world’s population and increases to 10 percent within the older age ranges.
Tennis elbow is quite prevalent in people whose jobs require gripping and lifting. It can occur afflict those who work a lot with tools, such as a mechanic or plumber, a carpenter using a screwdriver or hammer, a cook using a knife or lifting pots, or a desk worker using a computer mouse.
Previously thought to be an overuse injury with an active inflammatory process, recent evidence has demonstrated that it is degenerative in nature and without inflammation. That is to say that if one was to examine the tendon under a microscope there would be no inflammatory blood products, but the tendon would appear more worn out and tattered with small tears.
People who experience tennis elbow often suffer from the pain for several months to years. Unfortunately, those who are left untreated often develop a chronic problem. If you are going to attempt to treat it yourself, you should use the “RICE” principle which stands for “rest, ice, compression and elevation.”
If you happen to be suffering from this ailment you should see your doctor for a check-up. Your doctor will probably do an examination in which he or she twists and pokes your elbow to make sure that you are indeed suffering from tennis elbow symptoms. Once this diagnosis has been established, the doctor will determine the best route of care.
Research studies have found that a cortisone injection is the best treatment in the short term and that physical therapy treatment is the best treatment for the long term. There is also some evidence that an elbow strap as well as over the counter nonsteroidal anti-inflammatory drugs may be beneficial. Ultrasound and extracorporeal shock wave therapy have been found to be ineffective in the treatment of tennis elbow.
Physical therapists would probably prescribe some simple exercises to strengthen and stretch the forearm muscles. To be specific there is a lot of evidence that the lowering phase of the strengthening exercise, called eccentric strengthening, is the most beneficial exercise for degenerative tendon problems. They may also do a maneuver called “joint mobilization” that repositions your elbow joint. Lastly, don’t be surprised if they want to treat your neck as well, as this may be a culprit in your malady.
The best treatment for any disease is prevention. Maintaining a regular exercise regime is recommended by the American College of Sports Medicine. It is recommended that, at a minimum, Americans should do aerobic exercise for 30 minutes five days a week, and strengthening exercises at least twice a week.