Tennis elbow is known as lateral epicondylitis in the medical world. The condition is caused from partial tearing and inflammation in the muscles that extend the wrist and attach on the lateral side of the elbow. The cause of the inflammation and tearing can be from trauma, overuse or muscular strain. Microscopic exam of the injured area show small ruptures within the tendons of the extensor muscles in the wrist.
Tennis elbow is a common injury is racquet sports and in people who perform a lot of keyboarding. Occupations that involve twisting the forearm repeatedly such as painting or plumbing are at high risk for developing this condition. The symptoms can present as a local pain in the outer elbow or can radiate from the outer elbow down the forearm to the wrist and back of the hand.
Physical examination usually shows increased pain with resisted wrist extension called Cozens test and a weaker grip. Direct pressure over the insertion points of the extensors muscles will normally produce a sharp pain. X-rays of the affect arm are not normally necessary.
The initial treatment is rest and activity avoidance. Ice and NSAIDs are often used with good success. For cases related to employment, improving the ergonomic set-up and switching from a mouse to a roller ball may be beneficial. A counterforce brace that can be purchased at any drugstore can help anchor the tendons to the radius below the elbow thus reducing pressure on the humeral attachments.
Chiropractic management of tennis elbow is a comprehensive approach that may include adjustments and/or joint mobilization to the neck, shoulder, ribs, elbow and wrist. Myofascial release is often used over the supinator, pronater teres, bicipital tendon, anconeus and extensor muscles to break up fibrous adhesions within the muscles and increase pain free range of motion. Stretching the wrist flexors and extensors can help bring balance to the forearm and elbow. Cold laser therapy is commonly applied over the injured area to relieve pain and promote healing of the soft tissues.
For the low percentage of cases that are unresponsive to conservative care, a referral to a pain management doctor for cortisone injections may be necessary. Surgical options are a last resort but do offer high success rates.
The doctors at Frisco Spinal Rehab know exactly what to look for and do when diagnosing and treating tennis elbow and other elbow related issues. If you are suffering with pain around your lateral elbow, call our chiropractic and rehab clinic today for a full evaluation.