Tennis elbow (lateral epicondylalgia)
Why do you get a tennis elbow?
This is an overload injury to the outside of the elbow. It arises either gradually from one-sided, low-intensity loading of a tendon attachment on the outside of the elbow, such as during terminal work and raking, for example. Tennis elbow (lateral epicondylalgia) can also occur after heavier work such as carpentry, moving work, playing tennis. Previously, this diagnosis was called lateral epicondylitis, which indicates inflammation. This is misleading, as you can not normally see any inflammation in the painful area. The name has therefore been changed to epicondylalgia, which instead suggests pain in the area. Less than 5% of the population is affected and it is most common to get this at the age of 45-54 years.
Symptoms of lateral epicondylalgia
Pain outside elbow under load. Usually you do not have rest pain. The pain can pull down on the forearm and back of the hand. You can be sore at night or in the morning if you happen to lie badly with your arm / hand and put the tendon attachment in a stretch for a long time. On the bone committee on the outside of the elbow there is a well-defined pressure tenderness. Not infrequently, the muscles in the forearm are also sore. Sometimes forearm / hand is perceived as weak.
Treatment for tennis elbow
First of all, rest or minimize the activity that caused the tennis elbow, if one can now arrive at what it was. In cases where the problems have had a gradual onset, we also go through the neck and shoulder, as it is not uncommon for the problems to come from there in whole or in part.
The most important goal in the treatment of tennis elbow (lateral epicondylalgia) is to increase the load tolerance in the painful tendon attachment on the outside of the elbow. This is most conveniently done through eccentric training of the muscles on the outside of the forearm. That is, the load occurs in the phase when the muscle works in extension, slows the movement. As long as the problems do not worsen in general, it is ok that it hurts a little during the training. The training is initially performed once a day and as the load increases, the training sessions are sparse until they are performed every other day. Instruction and optimization of load is done together with your physiotherapist.
This training is usually combined with shock wave therapy in order to speed up healing in the area. This is a treatment we perform at Alta Vita Physiotherapy. It hurts a little just when you get this type of treatment, but we always adapt the treatment to what the patient thinks is manageable.
If the treatment does not lead to improvement, or if the intensity of the pain is intense, then this can be investigated further with us with the help of ultrasound diagnostics. Then we can see to what extent the tendon attachment in the elbow is affected, what it otherwise looks like in the area and in this way hopefully be able to clarify why the treatment does not progress.
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Forecast
In many cases, tennis elbow (lateral epicondylalgia) heals even without treatment and exercise. But if you do not perform the rehab training we recommend, then the risk is great that the problems will return when you load this area again. For a few patients who, despite well-performed rehab, do not get well, surgery may be necessary.
