Tennis elbow (aka lateral epicondylalgia) is a very common chronic musculoskeletal pain condition affecting the elbow. Data from Workcover Queensland indicates that upper limb (shoulder and elbow) injuries account for 21.5% of all work-related claims (2021) which is higher than back injuries.
Despite decades of research investigating treatments, it remains a challenging condition for both clinicians and patients (Bisset & Vicenzino, 2015). The first step for treatment is correct diagnosis and an understanding how it develops. The extensor muscles in your arm can get overloaded when your routine changes or ‘ramps up’ too quickly – stressing the muscle tendons passed their usual capacity.
DIY projects that take all weekend – using screwdriver, painting etc.
Returning to sports/gym after our extended lockdowns
Tendons absorb forces between muscle and bone. They stretch easily in response to gradually increasing forces, but forces above a tendon’s usual capacity can cause microtears (Cardoso et al., 2019). Multiple microtears lead to degenerative changes within the tendon (Vaquero-Picado et al., 2016).
It is understandable that people want to rest when experiencing pain associated with tennis elbow, but complete rest is not the best treatment. Tendons respond better with consistent loads/work. Research evidence supports a progressive strengthening program, rather than complete rest (Cardoso et al., 2019; Vaquero-Picado et al., 2016). Modifying activities that aggravate your pain is also important (Ma & Wang, 2020). This advice can and should be tailored for you by your practitioner.
During your consultations we can also help you with other treatment modalities for achieving pain relief, such as dry needling. Many different studies have investigated how dry needling works and show it can be an effective treatment for pain (Butts & Dunning, 2016; Kheradmandi et al., 2015), including a 2017 study that showed dry needling to be superior for lateral elbow pain relief at 6-month follow-up compared to ibuprofen 100 mg twice a day and a forearm brace (Uygur et al., 2017).
An experienced practitioner can offer various needling approaches and techniques to help with your particular pain symptoms and goals. For example in some circumstances needling shoulder muscles may have a significant and positive effect on pain, sensitivity and grip-strength for patients with tennis elbow (Kheradmandi et al., 2015).
Over the coming months I am happy to put together info about topics that interest our clients. Are there any questions you’d like to have answered? Email your questions to ….
Workcover Queensland. (2021). Workcover Queensland Annual Report 2020-2021.
Tennis elbow [image]. https://myphysioperth.com.au/tennis-elbow/
Bisset, L. M., & Vicenzino, B. (2015). Physiotherapy management of lateral epicondylalgia. Journal of Physiotherapy, 61(4), 174–181. https://doi.org/10.1016/j.jphys.2015.07.015
Butts, R., & Dunning, J. (2016). Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals. International Journal of Physical Medicine & Rehabilitation, 04(02). https://doi.org/10.4172/2329-9096.1000327
Cardoso, T. B., Pizzari, T., Kinsella, R., Hope, D., & Cook, J. L. (2019). Current trends in tendinopathy management. Best Practice and Research: Clinical Rheumatology, 33(1), 122–140. https://doi.org/10.1016/J.BERH.2019.02.001
Kheradmandi, A., Ebrahimian, M., Ghaffarinejad, F., Ehyaii, V., & Farazdaghi, M. R. (2015). The Effect of Dry Needling of the Trigger Points of Shoulder Muscles on Pain and Grip Strength in Patients with Lateral Epicondylitis: A Pilot Study. Jrsr, 3(3), 58–62. https://jrsr.sums.ac.ir/article_41077.html
Ma, K. L., & Wang, H. Q. (2020). Management of Lateral Epicondylitis: A Narrative Literature Review. In Pain Research and Management (Vol. 2020). Hindawi Limited. https://doi.org/10.1155/2020/6965381
Uygur, E., Aktaş, B., Özkut, A., Erinç, S., & Yilmazoglu, E. G. (2017). Dry needling in lateral epicondylitis: a prospective controlled study. International Orthopaedics, 41(11), 2321–2325. https://doi.org/10.1007/s00264-017-3604-1
Vaquero-Picado, A., Barco, R., & Antuña, S. A. (2016). Lateral epicondylitis of the elbow. EFORT Open Reviews, 1(11), 391–397. https://doi.org/10.1302/2058-5241.1.000049/ASSET/IMAGES/LARGE/10.1302_2058-5241.1.000049-FIG5.JPEG