Navigating Elbow Pain: Expert Tennis Elbow Treatment Approaches

Highlights: 

• Gain insights into tennis elbow and its treatments at our specialized hospital in Bangkok.
• Discover effective elbow pain treatments personalized to address tennis elbow and restore mobility.
• Trust our dedicated team to provide comprehensive care and help you achieve a pain-free lifestyle in Bangkok.

Tennis elbow is a widely used term referring to one of the most prevalent forms of tendinitis where people have suffered from pain on the outside of the elbow. Today, nearly half of all tennis players have, at some point, suffered from this disorder. Worth noting however, is that tennis players account for just 5 % of patients who visit physicians with this disorder.

Injury in the tendon and muscle attached to the bones on the outside the elbow causes the tendon inflammation. For instance, an accident could cause an acute injury or repetitive use over a long period of time could result in tendon degeneration. In addition, it could be from using falsely designed sports equipment or incorrectly playing sports. Being involved in jobs that require frequent lifting and dragging of heavy objects could also be the reason. It can come from jobs such as cleaning jobs that require frequent sweeping, wringing clothes and kitchen work too.

Often, the torn tendons have not been given time to heal completely before they are subject to being used again. In such cases, where tendons and muscles remain injured, the patient’s muscles are not at its optimal strength. This results in repetitive tears in tendons, causing inflammation and swelling. Consequently, this slows the repair mechanism in the body down by 6-12 weeks.

Even tendonitis, which is a degeneration in the tendon collagen from chronic overuse, can cause inflammation of the elbow. This is because the inflammation often involves a body area where the muscles and tendons are attached to the elbow bone or joint (epicondylitis).

• Recurring pain on the outside of the elbow
• Pain at the back of the hand that extends to the wrist
• The pain that intensifies when lifting objects, especially when the hand is faced down doing activities such as sweeping, washing dishes or stir-frying food.
• Some people experience severe pain and are unable to completely extend their hands or brush their teeth

A diagnosis is done taking into account a patient’s history, symptoms along with a physical examination. However, some symptoms are often get mistaken for tennis elbow. For instance symptoms like pain in the inside of the elbow joint or Golfer’s Elbow, or pain at the back of the elbow, called Bursitis. Instead, Bursitis is caused by a cyst, as indicated in the chart below.

Golfer’s Elbow Medial Epicondylitis

The pain is on the inside of the elbow and is similar to tennis elbow, except that the pain is felt around the joint inside of the elbow.

Olecranon Bursitis

The pain is on the back of the joint of the elbow, often caused by leaning of the elbow or arm on the table or from a direct blow on the elbow. A lump or cyst is often found in this area.

Since the pain is caused by an injury to the tendon in the specified area, the best treatment is to relax and stop the use of the hand that is in pain. When the pain alleviates, begin exercising your hand to strengthen the muscle. If you are required to return to work, the pain in your hand may aggravate or recur. Spend at least 5-10 minutes exercising your hand muscles before using it again.

Treatment using medication

Physicians generally prescribe anti-inflammatory medicines to patients in the first stage, when they are not experiencing great pain. If these medications are not effective in the treatment, the physicians will recommend steroid injections into the site of the inflamed tendon. This can alleviate the pain and inflammation but should not be used continuously over a long period of time, as it may cause side effects such as whitening of the skin around the injection site, fat atrophy, or rupture of the tendons.

If the above treatment is not effective, then surgery should be considered (about 3 % of patients who receive treatment opt for surgery) to remove the damaged tissue and to repair and tighten the tendons.

• Lift objects with palm facing up
• Exercise by regularly stretching your hand muscles
• Always do warm up exercises by stretching your hands before the start of any activity

Exercise 1:

Exercise your muscle by bending the wrist. Stretch your arms straight out in front of you, bend your palm downwards and bend it further down until you feel a stretch in your forearm.

Exercise 2:

Exercise the inside part of your arm by stretching your arms straight out in front of you, with your palm up. Bend your wrist down towards yourself. These two exercises are used to stretch the muscles and both exercises should be done for 15 seconds. Repeat this 2 or 3 times a day in three different intervals.

Continue to exercise your muscles to strengthen them. Do this by supporting your forearm on a table and have your hand hanging over the edge. Place your palm down towards the ground. Alternatively, sit on a chair and rest your hands on an armrest. Use a lightweight object that you can grasp on to, such as a bottle, and repeat exercises 3 to 6 below at least 30 times.

Exercise 3:

Exercise the hand muscles by holding on to an object with the palm facing down. Extend the wrist upward so that it is pulled back. Hold this position for 5 seconds, and then slowly release.

Exercise 4:

Exercise the inside of the hand muscles by holding on to an object with the palm facing up. Pull the wrist up and hold for 5 seconds, and then slowly release.

Exercise 5:

Exercise the muscles on the sides of the hand. Hold the object upright in the palm of your hand, and move your wrist up and down.

Exercise 6:

Exercise the muscles around the wrist of your hand. Continuing from the previous exercise, rotate your wrist. Turn the wrist inward as far as possible and hold for 5 seconds and then turn the wrist outward as far as possible and hold again for 5 seconds. Repeat this about 30 times

Exercise 7:

Massage gently by applying firm pressure using 2 fingers on the area of the pain. You may use some medication and rub the area of the pain for about 5 minutes. If you still have pain, apply an ice compress on the area.

• Stop engaging in any activity that causes pain in your elbow. If you must work, then do some warm up exercises to stretch your elbow muscles, at least 5-10 minutes before using your elbow and then immediately apply a cold compress after you have finished your work. Take short breaks between work.
• Use a stretchable cloth or a ready-made fabric as an elbow wrap or support. This will help reduce and protect against any force or impact with the elbow. Use this support while playing sports or lifting heavy objects.
• If your condition and pain persists for several days, consult a physician. If you allow the pain to continue and become chronic, you may lose the ability to move the elbow permanently, or the pain may be caused by other factors, such as gout, infection, inflammation or a nerve compression in the neck.

The Sports and Orthopedic Center also reaches out to anyone suffering from orthopedic injuries, or from acute or chronic damage to bones and joints. Our center brings together a highly accomplished team of 38 orthopedic surgeons, physical therapists and sports injury and physical rehabilitation experts. We pair these experienced experts with the latest orthopedic and physical rehabilitation equipment, ensuring all patients receive the best possible care.

Samitivej has a team ready to help and provide services for: 

• Treatment Plan Consultation with a doctor via online video-call (second opinion)
• Treatment Planning if you have medical records or a price estimate from another hospital 
• Cost Planning by our Appraisals Team with price guarantee (only for procedure packages without complications)
• Check Initial Coverage Eligibility with Thai and international insurance companies (only for insurance companies in contract with the Hospital)

Photo Credit: Marianne Bevis via Compfight cc