One of the more common complaints (outside of the spine) we hear in our practice is a painful, weak and/or numb elbow region and the most common diagnosis of these complaints is a syndrome known as “tennis elbow”.
Who Gets Tennis Elbow?
Trivia Time: 95% of those diagnosed with this condition are not tennis players!
That’s right, most people who suffer from tennis elbow are not tennis players, though most tennis players will get tennis elbow at some point in their careers.
Think you might have tennis elbow? See if any of these apply to you:
- Patients with tennis elbow usually present with elbow pain and forearm pain
- In severe cases, some patients may have numbness and/or shooting pain into their hands and neck.
- Tennis elbow sufferers will describe reduced strength in the affected arm(s), specifically when gripping, carrying or lifting everyday objects such as a toothbrush, a gallon of milk or a cup of coffee.
- Sometimes, the very act of straightening the arm is impaired or painful to perform.
- Golfers, who ironically make up a large percentage of the tennis elbow patients we treat, note that the act of striking the ground while hitting the ball will send painful shock-waves through their arm. Tennis players also report a similar pain when the ball meets the racquet during play.
- Hold your arm at your side, with your palm of your hand facing forward. Now, in this position (which anatomists call the “Anatomical Position”) pain in the outer or lateral part of the elbow and the upper part of the forearm just below the elbow joint is the common presentation of tennis elbow. This area contains a group of muscles/tendons that operate the forearm and attach to the bony bump (technically called the lateral epicondyle) you can feel on the outside of the elbow joint. If it is the inside of your elbow that fits this description, this is technically called Medial Epicondylitis or “Golfer’s Elbow”. Both conditions are treated identically, and since “Tennis Elbow” or Lateral Epicondylitis is much more common, we will use it interchangeably. The mechanism of injury is only slightly different.
If you think you might have tennis elbow, it is important to seek the advice of a reputable medical professional for an accurate diagnosis and treatment regimen.
What Causes Tennis Elbow?
Tennis elbow is classified as a Repetitive Stress/Strain Injury (RSI) caused by repetitive, forceful movements of the hand, wrist, and elbow. With tennis elbow, these repetitive, forceful movements could be the hundreds to thousands of swings a tennis player makes with their racquet and a golfer makes with their clubs during a match or tournament, but literally any repetitive motion, no matter how seemingly innocuous, can lead to injury.
For example, we’ve had patients present with the symptoms of tennis elbow at Integrated Physical Medicine after a long weekend of weed-eating, gardening, and typing. One unfortunate fellow developed it after assembling some furniture for his daughters’ first apartment; apparently screwing in the myriad of screws and other bits of hardware while building a complex piece of ready-to-assemble furniture was enough to significantly strain his elbow. Oddly enough, we’ve even seen an elderly woman who had a wicked case of tennis elbow after a marathon bingo session!
Physiologically, tennis elbow is the result of strained (microscopically torn) muscles and tendons which become inflamed and swollen causing pain and a limited range of motion of the elbow and possibly the wrist. In severe cases, the swollen muscles and tendons can mechanically compress sensory and motor nerves leading to weakness and numbness and/or tingling. These last symptoms often get mistaken for the signs and symptoms of a herniated or bulging cervical disc. Therefore, a “Good” Chiropractor will perform specific orthopedic and neurological tests to differentiate between these two conditions.
How is Tennis Elbow Treated?
The pain from tennis elbow generally lasts for about 6 to 12 weeks, but can also persist for years if the problem is not corrected.
An experienced chiropractor will recommend certain home-treatment measures to relieve tennis elbow. In our practice, we advise our patients to follow the RICE protocol while away from our office:
- Rest: Total rest, halt participation in the precipitating event until full healing has occurred. If this is not possible, a brace or strap will likely be prescribed.
- Ice: Ideally using an ice or cryomassage technique, but at least an ice pack, applied to the affected elbow, muscles and tendons for 20-30 minutes every 3 hours.
- Compression: A brace or strap may be worn to support the area. A compression sleeve can be employed to mechanically move out the inflammatory fluids and prevent their accumulation.
- Elevation: Keeping the affected elbow above the heart will also help reduce the accumulation of inflammatory fluids.
If a patient perfectly follows these home instructions, they will likely realize a reduction in their pain and some improvement in their function, though rarely to a level that most patients deem satisfactory. To get full resolution, a treatment plan designed by a reputable chiropractor must be followed. In our Evansville chiropractic practice, we address the typical tennis elbow from many different angles:
- We examine the region and locate any dysfunctions of the joints of the hand, wrist, elbow, shoulder, and neck. More often than not, joints that are not functioning well and bones not exactly aligned properly will be found and corrected. If left uncorrected, these problems cause compensations by the rest of the region that will almost guarantee at least a slow recovery if not a full relapse in the future.
- It is also crucial to increase the blood circulation to the elbow and forearm area and to reduce any muscle spasms. Our staff of chiropractic assistants, licensed massage, and physical therapists utilize various myofascial release massage techniques such as cross-friction massage, active release technique, and trigger point therapy. We also employ research-proven modalities like ultrasound, cold laser therapy, and acupuncture to accomplish a proper initiation of the healing cycle and reduce pain.
- Once the pain has been reduced by at least 50%, a comprehensive rehabilitation program will be prescribed and if followed, will ensure a maximum level of strength, function and injury prevention.
By following our treatment recommendations, the vast majority of patients with a complaint of tennis elbow or golfer’s elbow achieve their therapeutic goals.
Fix the Cause of the Problem and Not Just the Symptoms…
Another component that needs to be addressed by the patient, particularly an athlete, is a review of their form. More often than not, tennis elbow occurring in tennis players and golfers is a result of poor technique. Regardless of the causative event, the patient must consider the ergonomics of the task and look for a better, less abusive way to get the job done. For athletes, the obvious choice is to discuss your issues with a competent USGA or USTA teaching professional or the appropriate expert in your sport. If your injury is workplace-related, most companies have ergonomists on staff or will get one as a consultant. Of course, we are always available to discuss your specific concerns and help if we can with these sorts of issues.
Yes, chiropractic care helps with issues of every joint and muscle in the body!
People are often surprised to learn that we work on other parts of the body than just the spine. While this is no surprise to our long-term patients, who generally consult with us at Integrated Physical Medicine for virtually all of their aches and pains.