My Doctor says I have lateral epicondylitis…. What is it?
Lateral epicondylitis (LE, aka “tennis elbow”) is a condition in which the outer part of the elbow is painful, sore or irritable. (The condition is named for one of the structures that are being irritated- the lateral epicondyle, which is the bony prominence that is felt along the outer part of your elbow). While this condition can occur in people who participate in physical activities (such as tennis), it can also happen to those who do not participate in any sports. Along with tenderness to the lateral epicondyle, the muscles in the forearm are also sensitive to touch and painful.
Aside from primary symptoms of pain and irritability, the muscles of the elbow and/or wrist may feel weak and it can become increasingly difficult to perform routine daily activities (work, self-care or recreational).
Why does it happen?
One proposed cause of lateral epicondylitis is thought to be repetitive use/excessive exertion of the muscles. Overuse can occur because of work demands (excessive writing, typing) or physical activity. Coupled with that is the idea that there is decreased vascularization (blood flow) to certain areas of the body as we age. So, repeated strain to the elbow will cause minor tears to occur and it takes these tears a longer time to heal. And if one is performing the same motions multiple times within the day, it becomes easy to see how the trauma becomes cumulative and results in an irritable condition. In some cases, it may be difficult to pinpoint the exact cause of one’s painful symptoms. Whatever the aggravating incidents, it can be treated.
Signs and symptoms
The following is a list of signs and symptoms that may be experienced (this is not an all-inclusive list and some people may experience all or some of these symptoms):
- Lateral elbow pain (at rest or with activity)
- Point tenderness along lateral epicondyle or wrist extensor muscle mass
- Difficulty with writing, typing, gripping, lifting activities
- Repeated, exertional activities
- Radiating pain from elbow into forearm
- Forearm muscle soreness or muscle strain/tightness
- Swelling around elbow joint
What can be done to help?
Initially after being diagnosed, it is recommended to take some non-steroidal anti-inflammatory (NSAID’s) medications, which may help reduce pain and inflammation around the elbow. After being diagnosed with LE, it is important to assess daily activities and try to rest the elbow as much as possible. Another important initial step will be ice. Ice the elbow with an ice pack (or frozen peas) for 10 minutes or perform an ice up massage directly for 3 minutes. Most doctors may also recommend physical therapy to assist in regaining strength, increasing flexibility, reducing pain and restoring function with normal activities.
Why Physical therapy?
Physical therapy can be very important for a person diagnosed with LE. Below is a list of some of the things that are performed for patients with LE:
- Heat, ice
- Modalities (electrical stimulation, ultrasound, low level laser therapy) to help with pain reduction, swelling and inflammation
- Therapeutic exercises- may include strengthening exercises for elbow, wrist, and shoulder joints.
- Stretching- to help increase muscle flexibility
- Soft tissue massage to reduce any muscle tightness or muscle spasms
- Manual therapy treatment- which is important to assess elbow and wrist joint mechanics. Manual therapy will also provide resistance to muscles to help improve strength and mobilization techniques to improve joint mobility and flexibility.
- Home exercise program- so that people are able to perform these activities comfortably throughout the day
Part of the initial physical therapy evaluation will include questions regarding a client’s work, daily and recreational activities, so that we may assess performance of those activities and ways to correct them or make them more efficient.
*While there is no “cure” for lateral epicondylitis, physical therapy can provide symptom relief so that one will be able to return to their normal daily activities with less pain, improved strength and better function.