Treatment Options for Tennis Elbow

tennis elbow treatments
Learn options for treatment of tennis elbow.. PhotoAlto/Sandro Di Carlo Darsa / Getty Images

Lifestyle Modification

Changing the way you perform specific activities that aggravate your elbow pain symptoms can be one of the keys to success with tennis elbow treatment. Many  activities can lead to the pain of tennis elbow, not just racquet sports. Learning to avoid this pain, even with simple changes in the way you lift, can lead to a dramatic reduction of the pain from tennis elbow.

Changing How (and What) You Swing

Tennis racquets should be sized properly.

Higher stringing tensions may contribute to tennis elbow symptoms. Playing on harder surfaces also increases the risk of developing tennis elbow. Stroke mechanics should be evaluated to ensure patients are hitting the ball in the center of the racquet; players should not lead the racquet with a flexed elbow. See a tennis pro/instructor for a swing and racquet evaluation.

Anti-inflammatory Medications

Anti-inflammatory medications are often used to help control pain and inflammation. The oral forms of these medications are easy to take and often help control inflammation and manage pain. While these medications are probably not accelerating the healing process, they can help to provide relief. It is important, however, to be cautious that you don't overuse the elbow by masking the pain with medications--that pain is your body asking you not to do something, doing it can worsen the problem.

Cortisone Injections

One of the most commonly used treatments for tennis elbow is a cortisone injection. There is controversy about whether or not people should be using cortisone. First, it often provides excellent temporary relief, however, it may lead to overuse while the elbow is feeling better, only to lead to worsening symptoms once the effects have subsided.

Second, studies show no long-term benefit to cortisone for tennis elbow, and several studies show worse results when patients use this treatment.

Elbow Brace

An elbow orthosis, called an elbow clasp, can be worn. The theory behind using an elbow clasp is that the brace will redirect the pull of misaligned muscles. Patients often find relief of pain when using the clasp during activities. Some patients also find benefit with just a simple wrist splint. A wrist splint prevents excessive movement of the wrist tendons, which are the culprit of tennis elbow pain.

Tennis Elbow Exercises

Some simple exercises can also be helpful in controlling the symptoms of tennis elbow. These exercises should not cause pain, and those that do should not be done until pain resolves. By strengthening the muscles and tendons involved with tennis elbow, you can help prevent the problem from returning.

A new treatment for tennis elbow uses a strengthening tool called the Thera-Band FlexBar to relieve tennis elbow pain.

A recent study found that the patients who used the Thera-Band FlexBar had better success than patients who did not use this specific tool.

Extracorporeal Shock Wave Therapy

Shockwave therapy is a controversial treatment option for tennis elbow. The idea behind shockwave therapy is to use sound waves to induce so-called 'microtrauma' to tissues. This microtrauma initiates a healing response to alleviate pain. Results of studies investigating this treatment have been mixed. There is no strong evidence that shockwave is a better treatment than other options.

Autologous Blood Injection & PRP

A blood injection uses your own blood, drawn from a vein, and injected into the damaged tendon, in an effort to stimulate a healing response. Some studies have shown this to be a useful treatment, but not better than other treatments mentioned.

Platelet-rich plasma (abbreviated PRP) is a new treatment that is similar to an autologous blood injection. PRP is a concentration of platelet cells taken from your blood, and these platelets have growth factors that may help in the healing process of chronic injuries. The difference with PRP is that it uses a concentration of the blood that is withdrawn from your body.

Surgery For Tennis Elbow

There are several possible surgical treatments that have been successful. These include removing a portion of the damaged tendon or releasing the attachment of the affected tendon. A repair of the healthy portion of tendon is sometimes carried out as well. In addition, arthroscopic elbow surgery has become an option for some patients with tennis elbow.

Sources:

Edwards SG, Calandruccio JH. "Autologous blood injections for refractory lateral epicondylitis" J Hand Surg [Am]. 2003 Mar;28(2):272-8.

Haake, M, et al. "Extracorporeal Shock Wave Therapy in the Treatment of Lateral Epicondylitis" J. Bone and Joint Surg. (Am) 2002 84:1982-1991.

Jobe, FW; Ciccotti, MG. ""Lateral and Medial Epicondylitis of the Elbow" J. Am. Acad. Ortho. Surg., Jan 1994; 2: 1 - 8.

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