Tennis elbow – But I don’t even play tennis!

Medically known as lateral epicondylitis, tennis elbow is the inflammation of the ouside of the elbow.

The pain of tennis elbow is caused by inflammation of the tendon and periosteum (the outer layer of the bone) where the tendon from the back of the forearm joins the humerus (upper arm bone). The tendon connects the bone to the muscles that straighten the wrist. Any tension on that muscle – for example from a tennis backhand – will cause pain.

Tension on these muscles can be caused by all sorts of activities such as typing, writing, lifting objects with the palm turned down, or using a screwdriver. Even though there is inflammation, there is rarely any swelling. Stiffness and pain in the elbow can usually occur after prolonged periods of rest.

How do you know if you have tennis elbow? Try lifting a book with your palm facing down to the floor. If it causes pain on the outside of the elbow, you probably have tennis elbow.

This condition is ultimately due to overuse of the wrist extensor muscles. These muscles attach to the humerus just above the elbow joint on the outside of the elbow. The muscles then continue down the back of the forearm. The tendons then travel across the back of the wrist and hand and connect onto the fingers. These muscles contract to help extend the wrist moving it toward the back of the hand.

If this muscle group tightens too much, it will lead to a decrease in joint space in the elbow thereby resulting in an increase in pressure and inflammation in the joint. This results in pain in not only the epicondyle, but the radial-humeral joint as well.

Treatment normally consists of some lifestyle modification, plus anti-inflammatory and muscle relaxant medication. Physiotherapy such as TENS, ultrasound, laser therapy, and interferential current can also prove helpful.

Chiropractic techniques that work well with this condition include soft-tissue therapies such as active release technique, Graston, or cross-fiber friction massage. Chiropractic adjusting of the lateral elbow, including the proximal radial-ulnar joint and the radial-humeral joint, appear to be quite beneficial.

The aim of the chiropractic adjustment is to momentarily separate the joint surfaces in the elbow by just one to three millimeters. This takes the pressure off the joint, and eases the pain. It may be that some manipulation of the wrist can also help.

The theory is that since the muscles involved with this condition help to move the wrist, it should aid in the speed of recovery if the wrist motion is maintained. If the wrist tightens, the muscles need to work harder to move the wrist. This results in tightness in the wrist extensors which then exacerbates the condition.

The use of a tennis elbow band may also prove effective in decreasing symptoms. This works by forming an artificial origin for the muscle before it crosses the elbow. This allows a decrease in tension of the wrist extensor muscles as they cross the elbow which eases tension on the lateral epicondyle and decreases pressure on the elbow.

Of course rest would be the best medicine. But if you are not able to completely remove yourself from your chores, then be certain that when lifting to keep the palm of your hand turned upward so that the wrist flexors are used more that the wrist extensors.

Two things that have been found to help is to limit salt intake to help reduce water resorption in the body and to supplement with Vitamin B6.

Overall, if you suspect you may have this condition, it is best to have it assessed by your chiropractor and/or medical doctor in order to have the proper treatment plan started that will assist in accelerated recovery.