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Ask the Therapist?

Featured in the Town Observer Newspaper

by Carol Pietromonaco PT. - Physical Therapy Plus

Q. My husband works as a carpenter. Lately he’s been coming home with complaints of elbow pain after working a long day. He complains of a pain on the outside of the upper forearm just below the bend of the elbow. Occasionally it shoots down the arm towards the wrist. He also says he has difficulty straightening his elbow. At this point he also has pain when lifting or grasping light objects such as a coffee cup.

Based on his profession and the symptoms he is having , he is most likely experiencing something called “tennis elbow” 
• Pain that typically lasts for 6 to 12 weeks; the discomfort can continue for as little as 3 weeks or as long as several years. 

The damage that tennis elbow incurs consists of tiny tears in a part of the tendon and in muscle coverings. After the initial injury heals, these areas often tear again, which leads to swelling. 

Many medical textbooks treat tennis elbow as a form of tendonitis, which is often the case, but if the muscles and bones of the elbow joint are also involved, then the condition is called epicondylitis. If you see swelling, which is almost never a symptom of tennis elbow, you may want to investigate other possible conditions, such as arthritis, infection, gout or a tumor.

Relief Of Tennis Elbow
The best way to relieve tennis elbow is to stop doing anything that irritates your arm — a simple step for the weekend tennis player, but not as easy for the manual laborer, office worker, or professional athlete.

The most effective conventional and alternative treatments for tennis elbow have the same basic premise: Rest the arm until the pain disappears, then massage to relieve stress and tension in the muscles, and exercise to strengthen and stretch the area to prevent re-injury. If you must go back to whatever caused the problem in the first place, be sure to warm up your arm for at least 5 to 10 minutes with gentle stretching and movement before starting any activity. Take frequent breaks. Some wear a “forearm brace” to support the elbow during your daily activities and minimize pain.

For most mild to moderate cases of tennis elbow, aspirin or ibuprofen will help address the inflammation and the pain while you are resting the injury, and then you can follow up with exercise and massage to speed healing.

For stubborn cases of tennis elbow your doctor may advise corticosteroid injections, which dramatically reduce inflammation, but they cannot be used long-term because of potentially damaging side effects.

Prevention
To prevent tennis elbow: 
• Lift objects with your palm facing your body. 
• Try strengthening exercises with hand weights. With your elbow cocked and your palm down, repeatedly bend your wrist. Stop if you feel any pain. 
• Stretch relevant muscles before beginning a possibly stressful activity by grasping the top part of your fingers and gently but firmly pulling them back toward your body. Keep your arm fully extended and your palm facing outward. 

Call Your Doctor If.... 
• The pain persists for more than a few days; chronic inflammation of the tendons can lead to permanent disability. 
• The elbow joint begins to swell; tennis elbow rarely causes swelling, so you may have another condition such as arthritis, gout, infection or even a tumor.

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