Best Treatments for Tennis Elbow

What are the best treatments for tennis elbow?

Tennis elbow, or lateral epicondylitis, is a common condition that afflicts patients in their 30’s through their 60's. It causes pain and tenderness on the outer part of the elbow and forearm. Occasionally the pain can also radiate into the hand. It is usually not due to a single traumatic event, but more commonly, it arises from repetitive use of the forearm muscles. This wear and tear can lead to tiny tears in the tendons connecting these muscles to the bone on the outer part of the elbow (the lateral epicondyle area). This condition can be very painful and result in limited range of motion, weakness, and reduced quality of life. There are many treatments available for tennis elbow, and there are many products available online for purchase. Patients are often left wondering, "what are the best treatments for tennis elbow?"

The best treatments for tennis elbow are:

1. Rest and activity modification

A crucial step is to rest the affected arm and modify the activities which trigger the pain. It is okay to continue to use the hand and arm for light to medium-demanding physical activities. This allows the tendons to heal and reduces inflammation. Limit the activities that reproduce severe pain or activities which involve repetitive wrist twisting, heavy lifting, or forceful gripping. 

2. Pain and inflammation management

Over-the-counter pain relievers like ibuprofen or naproxen can help reduce the pain and inflammation. If you are unable to take NSAIDs, consider taking acetaminophen (Tylenol) occasionally for pain as needed. Apply ice or cold packs to the affected area for 15 minutes, 3-4 times a day, to decrease swelling and pain. Corticosteroid (cortisone) injections can also be used to relieve pain and swelling when the elbow pain is severe.

3. Support and bracing

Wearing a specialized elbow brace or forearm strap can help reduce stress on the injured tendons. A wrist splint can also be effective by immobilizing the wrist and indirectly resting the elbow tendons. Typically, our physicians and therapists at Raleigh Hand to Shoulder Center recommend wearing the wrist brace when sleeping or during the day when the pain is more severe.

4. Therapy and exercises

Stretching exercises of the elbow and wrist can be quite helpful with recovery. Once the severe pain subsides, exercise is helpful to strengthen the muscles and tendons in the hand, wrist, and forearm. Specific exercises can be helpful in regaining strength and preventing recurrence. It is often helpful to meet with an occupational or physical therapist for a few visits to ensure proper technique when performing these exercises. Specific exercises, such as wrist extension and flexion, towel twists, and ball squeezes, can help regain strength and range of motion. Therapy may also involve techniques like ultrasound, stretching, or massage to promote the tendon healing. 

5. Other non-surgical treatments for tennis elbow

Ultrasound therapy has been shown to increase blood flow and promote healing of the injured tendons. Iontophoresis is another treatment modality which can reduce pain in the area. Platelet-rich plasma (PRP) therapy, which involves injecting concentrated platelets from your blood into the affected area, is being explored to enhance tissue regeneration and healing. There have been some studies that have shown significant reduction in pain after PRP injections, while other studies have demonstrated more limited benefit. 

6. Tennis Elbow Surgery

Surgery is rarely needed for tennis elbow, but it may be considered if other non-surgical treatments have not helped after 6 to 12 months. Surgery typically involves removing the damaged portion of the tendon, scraping/drilling the bone to enhance healing, and occasionally reattaching the remaining healthy tendon back to the bone. 

If you have elbow or forearm pain that is not improving, it is recommended to consult with an upper extremity specialist. The specialist can confirm the diagnosis, evaluate for other possible causes of the pain, and offer additional treatments. The doctors at Raleigh Hand to Shoulder Center are here to help patients reach their goals, provide the best treatments for tennis elbow, and obtain the best result possible.