The key to tennis elbow (lateral epicondylitis) treatment is through tendon stimulation. Common treatments for tennis elbow are physiotherapy and cortisone injections, but it has long been misunderstood as to which treatment is best. Researchers have finally put treatment options for tennis elbow to test in order to uncover which one is the best to offer relief.
In many cases, tennis elbow will improve on its own without treatment, but patients may experience symptoms for years to follow. Lead researcher Morten Olaussen said, “Tennis elbow can be very distressing. Patients have to suffer persistent and often severe pain. They have reduced function in the elbow, and many have to go on sick leave.”
The researchers completed an in-depth literature review to determine the effectiveness of treatments for tennis elbow. They suggest that cortisone injections should be used with caution, as many patients experience relapse and the long-term effects are widely unknown.
The researchers reviewed the effects of no treatment for tennis elbow, physiotherapy treatment alone, and physiotherapy combined with cortisone injections. The research took form of a randomized, placebo-controlled study where patients were divided into three groups and were monitored for one year.
The researchers found that two-thirds of patients recovered without any treatment. For the remaining one-third who still experienced symptoms after a year, further treatment was required and physiotherapy alone was no more effective than no treatment at all.
Olaussen added, “It came as a surprise that physiotherapy, especially eccentric exercise, did not help. This type of exercise has otherwise proved to be effective for chronic symptoms. Perhaps the acute condition that we have studied is an infection that later develops into a chronic condition, with changes in the tissue and tendon? Or possibly the combination of the different types of physiotherapy that we used was detrimental.”
Physiotherapy combined with cortisone injections led to short-term results, and after one year’s time all three groups experienced the same improvements.
“The main conclusion was that two-thirds of patients with acute tennis elbow recover after one year without any special treatment.” Olaussen concluded. “In our study, physiotherapy had little effect. If you need a quick recovery, cortisone injections together with physiotherapy may be appropriate. Many people will then experience a quick recovery, but symptoms will temporarily worsen after a while. This means that we cannot recommend this treatment to everyone, even though it has no long-term detrimental effect.”
Treating epicondylitis, saline injections as effective as platelet-rich plasma injections
Another study compared treating tennis elbow with either saline injections of platelet-rich plasma (PRP) injections, and found that saline injections were equally as effective. Lead researcher Patrick Le Goux explained, “While PRP injections were shown to have no inherent benefit in the treatment of epicondylitis, what is exciting is that pain scores in both treatment groups decreased significantly over the course of the trial. The healing process is stimulated by the echo-guided injection of a substance and/or by the own effect of the needle (needling); the injections stimulate the process of tendon repair through an irritation effect, a technique known as prolotherapy.”
The researchers administered injections every four weeks of either PRP injections or saline, and were evaluated every one, three, six and 12 months. The study consisted of 50 patients with confirmed tennis elbow, but only 44 participants completed the study.
After six months, no statistical differences were found in either group. At six months 34 percent of all patients were asymptomatic, and at 12 months 66 percent of patients were asymptomatic. At 12 months, only 23.8 percent of patients still experienced symptoms.
Tennis elbow home treatment options
Different studies reveal that you don’t necessarily need injections when it comes to treating tennis elbow, and that home treatment options may very well be an effective mode of treatment. Here are some tips to help treat and improve tennis elbow:
- Rest your hand, fingers, and forearms, and stop activities that may aggravate these tendons.
- Apply ice and hot packs to the area – alternating between cold and hot may offer relief and reduce swelling.
- Wear a counterforce brace when partaking in activities that involve the hand, forearm, and fingers.
- Try elevating the elbow when in pain.
- Use over-the-counter pain medications.
- Do simple exercises and warm-ups to prevent the tendons from becoming stiff.
- Massage in avocado oil or calendula oil, which can improve inflammation.
- Combine fenugreek and milk to make a paste and apply it to the painful area like an ointment – consuming fenugreek can also give you the benefit of its anti-inflammatory properties.
- Consume garlic to reduce inflammation in the body.
- Complete stretches and strengthening exercises gradually when the pain goes away.
These home remedy tips can help you improve your tennis elbow and speed up recovery.
Conditions such as tennis elbow, golfer’s elbow, and cubital tunnel syndrome are common elbow pain causes. The elbow is a hinge joint located between the humerus and the upper arm. Along with the bicep muscles, the elbow allows for bending and rotating, and the ligaments allow for stabilization. Continue reading…
Tennis elbow, or lateral epicondylitis, is a condition that encompasses the overuse of the forearm, arm, and hand muscles, which creates elbow pain. Although it is commonly referred to as tennis elbow, it is not only experienced by tennis players; the term only came about because the condition was quite common among tennis players. Continue reading…