Elbow Pain: Treatment Options for Tennis Elbow

Elbow joint pain

Dear Director Shi,
I would like to consult you regarding an issue with my elbow joint.
My right wrist to elbow area has been injured since last summer (93rd year), and I have seen several traditional Chinese medicine practitioners for treatment, including topical applications and rehabilitation, but none have been effective, so I eventually gave up on treatment.
Recently, I visited an orthopedic clinic, and the doctor diagnosed me with tennis elbow.
He administered an injection (which he described as an anti-inflammatory injection) at the site of wrist pain and also performed electrical therapy.
After returning home, I did feel a reduction in pain; however, once the medication wore off, even the prescribed medication did not seem effective, and the pain persisted.
I then switched to a newly opened traditional Chinese medicine clinic near my home.
The rehabilitation therapist there mentioned that my elbow joint has developed adhesions, as it has become deformed, preventing me from fully extending it or touching my shoulder.
I have also missed the optimal treatment window, so it will take about two weeks of rehabilitation.
The therapist performed some spinal manipulation and twisted my right hand outward until I heard a slight popping sound at the joint.
The pain was intense, causing me to cry out, and afterward, I experienced dizziness and numbness in my hands due to the pain.
After resting, I did notice a slight improvement in the bending angle of my elbow.
I would like to ask you, Director Shi, should I continue rehabilitation with the traditional Chinese medicine practitioner? Are there other treatment options available for my elbow? Is there hope for complete recovery? I am very concerned as I have been in pain for too long, and I worry about the possibility of my hand becoming unusable, which would affect my ability to work and support my children in the future.
I hope you can take the time to answer my questions, and I would be very grateful.
Thank you for your guidance!

Angel, 40~49 year old female. Ask Date: 2005/04/17

Dr. Shi Guozheng reply Orthopedics

I'm not very familiar with traditional Chinese medicine treatment methods.
Based on your description, the symptoms appeared after an injury to the elbow joint, which may have affected the tendons or ligaments.
From an orthopedic perspective, it is usually recommended to get an X-ray first to check for any bone issues.
If it's just a tendon problem, you can go to a rehabilitation department for physical therapy, which should be quite effective, so it's worth trying.

Reply Date: 2005/04/17

More Info

Tennis elbow, or lateral epicondylitis, is a common condition characterized by pain on the outer part of the elbow, often resulting from repetitive motion or overuse of the forearm muscles and tendons. The pain can radiate down the forearm and can significantly impact daily activities and quality of life. Given your situation, it seems that you have been dealing with this condition for quite some time, and I understand your concerns regarding the ongoing pain and potential long-term implications.

Understanding Tennis Elbow
The primary cause of tennis elbow is the overuse of the muscles and tendons in the forearm, which leads to inflammation and micro-tears in the tendon that attaches to the lateral epicondyle of the humerus. Activities that involve repetitive wrist and arm motions, such as playing tennis, painting, or even typing, can exacerbate this condition. Symptoms typically include pain and tenderness on the outer elbow, weakness in the forearm, and discomfort when gripping or lifting objects.

Treatment Options
1. Rest and Activity Modification: The first step in managing tennis elbow is to rest the affected arm and avoid activities that exacerbate the pain. This may involve modifying your daily activities or taking breaks during repetitive tasks.

2. Physical Therapy: Engaging in physical therapy can be highly beneficial. A physical therapist can design a tailored rehabilitation program that includes stretching and strengthening exercises to improve flexibility and strength in the forearm muscles. They may also use modalities such as ultrasound, electrical stimulation, or heat therapy to alleviate pain and promote healing.

3. Bracing: Using a forearm brace or a tennis elbow strap can help reduce strain on the elbow by resting the muscles and tendons. This can be particularly useful during activities that may trigger pain.

4. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. If oral medications are not effective, corticosteroid injections may provide temporary relief.

5. Alternative Therapies: Some patients find relief through alternative treatments such as acupuncture or chiropractic care. However, it’s essential to consult with a qualified practitioner and ensure they have experience treating tennis elbow.

6. Surgery: If conservative treatments fail after several months, surgical options may be considered. Surgery typically involves removing degenerated tissue or repairing the tendon.

Your Current Situation
Given that you have already undergone various treatments, including injections and physical therapy, it is understandable to feel frustrated with the lack of significant improvement. The mention of "adhesion" and joint deformity by the therapist indicates that there may be more complex issues at play, such as scar tissue formation or chronic changes in the elbow joint.

Recommendations
1. Continue Physical Therapy: If you are experiencing some improvement with the current therapy, it may be worth continuing with the physical therapist. They can help you regain mobility and strength in your elbow. Ensure that the therapist is aware of your pain levels and any discomfort during treatment.

2. Seek a Second Opinion: If you feel uncertain about the current treatment plan or the diagnosis, consider seeking a second opinion from an orthopedic specialist who focuses on elbow injuries. They can provide a comprehensive evaluation and discuss potential advanced treatment options.

3. Stay Informed: Educate yourself about tennis elbow and its treatment options. Understanding your condition can empower you to make informed decisions about your care.

4. Be Patient: Recovery from tennis elbow can take time, especially if the condition has been chronic. Consistent rehabilitation and adherence to treatment recommendations are crucial for long-term recovery.

In conclusion, while tennis elbow can be a challenging condition to manage, many patients do achieve significant improvement with appropriate treatment. It’s essential to remain proactive in your care and communicate openly with your healthcare providers about your concerns and progress. With dedication and the right approach, there is hope for recovery and a return to your normal activities.

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