Effective Strategies for Managing Chronic Lateral Epicondylitis - Orthopedics

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Chronic lateral epicondylitis, commonly known as tennis elbow, can be a frustrating condition, especially when conservative treatments fail to provide relief. Given that you've been experiencing symptoms for five months and have undergone multiple treatments without success, it's important to explore additional strategies for managing your condition effectively.


Understanding Lateral Epicondylitis
Lateral epicondylitis is characterized by pain and tenderness on the outer part of the elbow, which can radiate down the forearm. It is typically caused by repetitive strain or overuse of the forearm muscles and tendons, particularly those involved in wrist extension. This condition is common among individuals who engage in repetitive arm movements, but it can also occur in those with sedentary jobs that require prolonged use of the wrist and hand.


Effective Management Strategies
1. Activity Modification: Since your job as a stock trader may involve prolonged periods of typing or using a mouse, consider modifying your work environment. Use ergonomic tools such as a wrist rest, an ergonomic mouse, or a keyboard that minimizes strain on your wrist. Taking regular breaks to stretch and rest your arm can also help reduce symptoms.

2. Physical Therapy: While you have undergone ultrasound and infrared treatments, a tailored physical therapy program focusing on strengthening and stretching the forearm muscles may be beneficial. A physical therapist can design a program that includes specific exercises to improve flexibility and strength, which can alleviate strain on the elbow.

3. Bracing: Using a forearm brace or a counterforce brace can help reduce strain on the elbow by distributing pressure away from the painful area. This can be particularly useful during activities that exacerbate your symptoms.

4. Alternative Treatments: If corticosteroid injections have not provided relief, you might consider other options such as platelet-rich plasma (PRP) therapy or dry needling. PRP therapy involves injecting a concentration of platelets derived from your blood into the affected area, which may promote healing. Dry needling targets trigger points in the muscles to relieve pain and improve function.

5. Pain Management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. However, it's essential to use these medications as directed and consult with your healthcare provider if you have any concerns.

6. Surgical Options: If conservative treatments fail after an extended period (usually six months to a year), surgical intervention may be considered. Surgery typically involves removing degenerated tissue or repairing the tendons. This option should be discussed thoroughly with an orthopedic surgeon specializing in elbow conditions.

7. Lifestyle Changes: Incorporating regular low-impact exercises, such as swimming or cycling, can help maintain overall fitness without exacerbating elbow pain. Additionally, consider engaging in activities that promote overall well-being, such as yoga or pilates, which can enhance flexibility and strength.


Conclusion
Managing chronic lateral epicondylitis requires a multifaceted approach, especially when initial treatments have not been effective. By modifying your activities, engaging in targeted physical therapy, considering alternative treatments, and possibly exploring surgical options, you can improve your chances of recovery. It’s crucial to maintain open communication with your healthcare providers to ensure that your treatment plan is tailored to your specific needs and to monitor your progress closely. If symptoms persist or worsen, do not hesitate to seek further evaluation and treatment options.