From the Guidelines
Treatment for tennis elbow should begin with conservative approaches, including rest, ice, and activity modification, as well as physical therapy focusing on specific stretching and strengthening exercises for the forearm muscles, as this approach has been shown to be highly effective in managing the condition 1. The goal of treatment is to reduce strain on the affected tendon, promote healing, and manage pain and inflammation.
- Conservative management options include:
- Relative rest and reduced activity to prevent further damage and promote healing and pain relief 1
- Cryotherapy to provide acute relief of tendinopathy pain 1
- Eccentric strengthening to reverse degenerative changes and promote healing 1
- NSAIDs for short-term pain relief, although they have no effect on long-term outcomes 1
- Additional treatment options include:
- Counterforce braces to redistribute forces away from the injured tendon during activities
- Corticosteroid injections for temporary relief, although they are generally limited to 2-3 injections due to potential tendon weakening with repeated use
- Platelet-rich plasma injections, which use components of your own blood to promote healing
- Surgery is reserved for cases that don't respond to conservative treatment after 6-12 months, involving removal of damaged tissue and reattachment of healthy tendon 1. It's essential to note that most cases of tennis elbow resolve within 6-12 months with appropriate conservative management, as the condition results from repetitive stress causing microtears in the tendon that attaches forearm muscles to the bony prominence on the outside of the elbow 1.
From the Research
Treatment Options for Tennis Elbow
Tennis elbow, also known as lateral epicondylitis, is a common musculoskeletal disorder that causes pain and tenderness on the outside of the elbow. The treatment options for tennis elbow can be categorized into several approaches, including:
- Conservative Treatment: This approach includes relieving inflammation and pain with rest, ice, anti-inflammatory medications, and occasionally cortisone injections 2. It also involves promoting the healing process with high-voltage galvanic stimulation, exercises for strength, endurance, and flexibility in the arm and forearm, and reducing the overload forces that caused the original injury by using a counterforce brace and modifying the player's technique and equipment 2.
- Physiotherapy: Physiotherapy plays a crucial role in the treatment of tennis elbow, focusing on pain management, functional recovery, and recurrence prevention 3. Physiotherapy techniques may include manual treatments such as joint mobilizations, soft tissue massage, and myofascial release, as well as exercise rehabilitation, including eccentric training and progressive resistance exercises 3.
- Modalities: Modalities such as ultrasound, laser therapy, and cryotherapy may be used to treat pain and enhance joint function 3, 4. Cryotherapy is found to be effective in the acute stage, while nonsteroidal anti-inflammatory drugs and heat are effective in the subsequent stages 4.
- Rehabilitation: Rehabilitation should run parallel to treatment, including strengthening exercises to promote recovery and prevent recurrence 5. Two types of exercise can help regain strength: exercises with weights and exercises without weights 5.
- Surgical Treatment: Surgery may be required as a last resort in patients with chronic symptoms 2.
Key Principles of Treatment
The key principles of treatment for tennis elbow include:
- Relieving pain, microbleeding, and inflammation
- Promoting healing
- Rehabilitating the injured arm
- Preventing recurrence
- Using simple and conservative treatments before progressing to more complex and invasive therapies 4
Additional Considerations
Additional considerations in the treatment of tennis elbow include: