How do I know if I have tennis elbow or not?
The majority of the patients complain of pain located just anterior to, or in, the bony surface of the upper half of the lateral epicondyle, usually radiating in line with the common extensor mass. The pain can vary from intermittent and low-grade pain to continuous and severe pain which may cause sleep disturbance.
It is typically produced by wrist and finger extensor and supinator muscle contraction against resistance. The pain lessens slightly if the extensors are stressed with the elbow held in flexion.
Range of motion is not usually affected. Motion may be painful in more advanced stages where it can be elicited in full elbow extension with the forearm pronated. If limited motion exists, other concomitant pathology needs to be excluded. There are many tests employed in LE physical examination. Maudley’s test, Thomson’s manoeuvre, diminished grip strength and the ‘chair’ test are some of the tests employed to reproduce the pain of tennis elbow.
Diagnosis
Ultrasound is one of the most useful tools to diagnose or rule out LE.
Structural changes affecting tendons (thickening, thinning, intra-substance degenerative areas and tendon tears for example), bone irregularities or calcific deposits can be detected.
Magnetic resonance imaging (MRI) is more reproducible, reduces inter-operator variability and gives more information about intra-articular pathology. Unfortunately, findings on MRI are not well correlated with the severity of clinical symptoms, and is an expensive modality to be used routinely for such a common condition.
Physiotherapy Treatment for Tennis Elbow
Our physiotherapists at Curezone physiotherapy Mississauga implement evidence-based exercises and treatment based on individual needs and condition. The stretching and strengthening exercises are based on individual muscle strength affected in Tennis elbow.
They also recommend different treatments for both tennis elbow and golfer’s elbow.
According to the studies done so far, the following treatments can help but doesn’t apply for all cases:
Stretching and strengthening exercises: Special exercises that stretch and strengthen the muscles of the arm and wrist.
Manual therapy: This includes active and passive exercises, as well as massages.
Painkillers: especially non-steroidal anti-inflammatory drugs (NSAIDs).
Ultrasound therapy: The arm is exposed to high-frequency sound waves. This warms the tissue, which improves the circulation of blood.
The main treatment for symptom relief is usually a combination of stretching and strengthening exercises. NSAIDs are an option for short-term treatment.
Braces / bandages: These are worn around the elbow or on the forearm to take strain off the muscles.
Injections: Injections into the elbow with various substances, such as Botox, hyaluronic acid or autologous blood (the body’s own blood). Some times Steroid injections are also used to subside the pain in severe cases.
Extracorporeal shockwave therapy (ESWT): A device generates shock or pressure waves that are transferred to the tissue through the skin. This is supposed to improve the circulation of blood in the tissue and speed up the healing process.
Laser therapy: The tissue is treated with concentrated beams of light. This is supposed to stimulate the circulation of blood and the body’s cell metabolism.
Transcutaneous electrical nerve stimulation (TENS): TENS devices transfer electrical impulses to the nervous system through the skin. These are supposed to keep the pain signals from reaching the brain.
Acupuncture: The acupuncture needles are inserted into certain points on the surface of the arm. Here, too, the aim is to minimize the perception of pain.
Cold: The elbow is regularly cooled with ice packs.
Transverse or cross friction Massages: A massage technique called “transverse friction massage” is often used to treat tennis elbow and golfer’s elbow. It is applied to the tendons and the muscles, using the tips of one or two fingers.
To find out what works best for you, call us at curezone physiotherapy 905 997 4333!!!
