How to treat lateral epicondylitis or tennis elbow?

physiotherapy-CMI-clinic-epicondylitis

Lateral epicondylitis is a musculoskeletal condition that frequently affects men and women between the ages of 35 and 54 and impacts approximately 1 to 3% of the general population. Manual workers and tennis players are more at risk, hence the common name, tennis elbow. It consists of repetitive strain injuries to the tendon of the wrist extensor muscles, which attaches to the lateral epicondyle of the elbow (the bony prominence on the outer side of the elbow).

Causes

Lateral epicondylitis can occur in two ways: as a result of trauma or, more often, as a result of overuse of the muscle. Depending on its severity, it can heal in 6 weeks to 12 months. If it persists for more than 12 months despite conservative treatment, surgery may be considered.

Symptoms

The primary point of pain is usually located on the outer side of the elbow near the bony prominence and along the muscles leading to the wrist. Various signs are characteristic of epicondylitis, namely an increase in pain:

  • When palpating the elbow externally;
  • When resisting the upward movement of the wrist;
  • When squeezing an object with your hand.

Physiotherapy treatment

It is recommended to avoid as much as possible the movements that cause the pain and gradually increase the level of effort required from the tendon. Your physiotherapist will be able to teach you the appropriate progression of exercises, but first, he or she will confirm that it is indeed epicondylitis. Physiotherapy treatment will be specific to your condition and will include manual therapy, Cyriax friction, eccentric strengthening and myofascial stretching to accelerate healing. Strengthening and stretching exercises will also be prescribed. Ice may be effective in reducing pain. Adopting proper work posture and taking breaks will help to reduce the strain on the forearm muscles.

Depending on your condition, your doctor may prescribe anti-inflammatory drugs (NSAIDs), a corticosteroid injection, a resting brace or epicondylar band to reduce pain and overload in the tendon, or a platelet-rich plasma (PRP) injection.

If you experience any of the above signs and symptoms or if there is no improvement within a few days of the onset of pain, consult your physiotherapist promptly. The longer it takes to consult your physiotherapist, the more demanding the rehabilitation will be.

Coombes, Brooke K., Bisset, Leanne et Vicenzino, Bill. Management of Lateral Elbow Tendinopathy: One Size Does Not Fit All. Journal of Orthopaedic and Sports Physical Therapy, Nov 2015, vol 45, num 11.

Knutsen, Elisa J. et al. Factors Associated With Failure of Nonoperative Treatment in Lateral Epicondylitis. American Journal of Sports Medicine, Sept 2015, vol 43, num 9, p.2133-2137.

Chesterton, Linda S., Mallen, Christian D., Hay Elaine M. Management of Tennis Elbow. Open Access Journal of Sports Medicine, Avril 2011, num 2, p. 53-59. 53-59.

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