Tennis elbow is a common name for a painful, lateral elbow. Though it may occur in tennis players, this condition is prevalent in many others, including rock climbers, tradespeople, and office workers.
This condition is known by other names including lateral epicondylalgia, lateral epicondylitis and lateral extensor tendinopathy. This is one of many tendinopathies in the human body.
As with all conditions, it is important that it is correctly diagnosed. For example, an issued from the neck can also cause pain in the elbow in what is called a cervical radiculopathy. Pain in the elbow from a tendinopathy vs pain in the elbow from a radiculopathy should be clearly delineated and treated accordingly. If you do have an acute case of lateral epicondylalgia, 3/4 cases resolve on their own within 52 weeks.
If you do arrive at a diagnosis of Tennis Elbow, what is the treatment with the best results? A new systematic review has found eccentric exercise has a good evidence base and may be more effective in treating this type of tendinopathy compared to other types of treatment. Some examples of eccentrics are provided below.
Other treatment options? A recent randomized control trial compared acupuncture and manipulation of the elbow. Manipulation of the radial head provided relief more quickly than acupuncture, but by 8 weeks both groups showed similar results. It does not appear that the group followed the subjects up past 8 weeks, which is a problem as recurrence is can occur.
What about cortisone? Well, cortisone may be effective in the short term for some people, but it will make it worse at 12-26 weeks compared to placebo or conservative management alone. So, if you had a big tournament coming up, multimodal treatment with cortisone might be something that gets you through the event; but it will make it worse a few weeks later. The mainstay of your rehabilitation is either wait and see approach, or strengthening and load management.
Soft tissue treatments, stretching, dry needling, Mills Maneuver may be effective for some individuals, also; however, eccentric exercises seem to have the most amount of quality research behind them at the moment. 3 sets of 15 eccentric only exercises are the most frequently prescribed and tested exercises. A few examples are provided below, however, consult a chiropractor, physiotherapist or your GP prior to commencing any exercise routine.