Lateral Epicondylalgia - Tennis Elbow
Have you ever experienced pain through your elbow, particularly the outer side? Has your GP diagnosed you with tennis elbow and left you wondering what you should do?
Lateral epicondylalgia (more commonly referred to as tennis elbow) is the most common injury to affect the elbow. Research has shown that 40% of people will suffer tennis elbow at some point in their life, and it is most common between the ages of 35-54 years old. Anyone who plays a racquet sport or has a manual or repetitive job is most at risk.
Tennis elbow can occur from an unaccustomed physical activity or from a direct blow, and results in degenerative changes through the common extensor tendon also known as a tendinopathy. The common extensor tendon is located through the outside part of the elbow, and is used when straightening the fingers and bringing the wrist backwards.
There are three main stages of tendinopathy; reactive tendinopathy, tendon disrepair and degenerative tendinopathy. The important thing with these stages is that the stage of tendinopathy doesn't directly relate to pain and function loss, and that the body is very good at adapting.
Some common worries around tennis elbow and tendionpathies include: - Will my tendon snap if I use it? Is there inflammation in the tendon? Will complete rest help? Firstly, complete rupture of the extensor tendons is very uncommon and is more associated with a traumatic event rather than day to day activities. Secondly, the old belief was that the tendons are inflamed in a tendinopathy; however, recent studies of affected tendon tissue have shown it is possible to have inflammation in the tissue surrounding the tendon but not through the tendon itself. And finally, it is importance to realise that tendons are required to do some work to improve, and this is where it is important to seek advice from your physio or GP.
Current scientific research shows that physiotherapy has a good effect at speeding up the healing process and at reducing pain. Treatment starts with diagnosis by either your General Practitioner or physiotherapist, and is sometimes confirmed with ultrasound. From there, physiotherapy treatment will consist of load management strategies, soft tissue massage, joint mobilisations at the neck and elbow, and gentle exercises to work the damaged tendon, causing it to self-repair. Other treatment options can include strapping or bracing, dry needling and cortisone injections.
If you have pain through your elbow that isn't settling, discuss your symptoms with your GP or physiotherapist and start the process sooner to a pain free, easier life.