Should You Allow Your Doctor to Give You Cortisone Shots for Tennis Elbow?
What is Tennis Elbow?
Tennis elbow is a painful elbow disorder. It is a condition where the outer part of the elbow becomes painful and tender, usually as a result of a specific strain or overuse. It is caused through either subtle or abrupt injury of the muscle and tendon around the outside of the elbow and It is common in tennis players, (hence it's name) but most people get tennis elbow from other activities that work the same muscles, such as playing the violin or fiddle, gardening, painting, using a screwdriver or hammer. It is also associated with jobs that require repeated and/or forceful movements of the fingers, wrist, and forearm. Studies have shown that tennis elbow, (otherwise known as lateral epicondylitis) is most common in adults between the ages of 35 and 55 and as it is an overuse injury it can be prevented.
Tips for Helping Tennis Elbow
What are the symptoms of tennis elbow?
Symptoms of tennis elbow include pain that slowly increases around the outside of the elbow, that returns to top of the elbow and that gradually worsens. It radiates from the outside of the elbow to the forearm and back of the hand when grasping or using a twisting motion. Symptoms are further exacerbated by gripping or lifting even light objects.
The symptoms of tennis elbow are usually distinct, but in some cases they can be confusing as the injured area may be as a result of an incomplete healing response in an area that has poor blood circulation and therefore has difficulty accessing nutrition and oxygen which are necessary for good healing to take place.
Below are some of the common symptoms of tennis elbow:
- Inability to carry objects or use your arm
- Elbow pain that occurs at night or while resting
- Elbow pain that persists beyond a few days
- Inability to straighten or flex your arm
- Swelling or significant bruising around the joint or arm
- Any other unusual symptoms
If you are a suffer from any of the above then get a diagnosis from your doctor as to what is causing your discomfort.
What is Tendinosis?
new research showing tennis elbow as a tendinosis not a tendinitis injury
New Research on Tennis Elbow
There is new research that has shown that tennis elbow isn't an anti-inflammatory (tendinitis) condition as previously thought but that it has shown to be tendinosis condition. The difference between these two conditions is that with tennis elbow there doesn't seem to be evidence of inflammation at the injured site. So rather than being a condition initiated by the lymphatic system it is a condition of degenerative healing within the tendon itself.
Another finding is that the use of cortisone injections as a treatment therapy don't work as they do not alter the pathological degenerative processes that occur in tendinosis (they can cause more damage to the area). What has been concluded is that a cortisone injection should only be given if the patient is unable to perform rehabilitative exercises because of pain. But that by far the best form of therapy for tennis elbow or any other tendinosis condition is a resistance based exercise program - beginning with low resistance and low repititions, building up both the intensity and number of repetitions until the injury has healed. Another point is that concentric contraction exercises - where the muscle shortens, performed slowly shoud make up the rehabilitative exercise program, combined with stretching.
Causes of Tennis Elbow
Causes for tennis elbow can include direct injury to the area as a result of a fall, motor vehicle accident, work related injury or sports related injury as well as overuse of the wrist joint in carrying, repetitive lifting, or performing fine hand manipulations e.g playing the violin.
These causes can be broken down into the following areas:
Muscle weakness, (when playing racquet sports - especially when using the single handed backhand stroke, fast court where the tennis balls are travelling very fast or heavy tennis balls.
Sudden injury, such as when falling down, trapping the arm etc.
Repetitive use of the arm, when doing carpentry or using electrical screwdrivers where there is a lot of vibration felt in the arm.
Any combination of repetition and force together .
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Therapies for Healing Tennis Elbow
The most important steps in the treatment of tennis elbow that you can do yourself include:
- rest from the activities that cause the elbow discomfort,
- use of ice packs, ice massage or medication /essential oil massage to reduce inflammation (if there is any) and pain.
Visiting a physiotherapist or physical therapist will help you to restore the elbow to its highest functioning level and help you in returning to work and playing sport.
Some of the treatments that physiotherapists use to treat tennis elbow include TENS machines, laser therapy, ultrasound, and interferential current.
Some doctors prescribe the use of heat therapy, such as warm compresses, and treat with ultrasound, and physical therapy, (manipulation and massage) to release the discomfort of their patients and heal their condition. Massage therapy can relieve muscle tension, improve blood flow, improve lymph flow, relieve pressure on the nerves, restore normal joint movement and when combined with essential oil the healing time is accelerated.
Prevent Tennis Elbow Re-occuring
To prevent an old tennis elbow injury from coming back, you should
- continue to do strengthening exercises to keep the elbow and wrist joints mobile and strong
- give yourself proper rest between playing sessions,
- don't play sport or your musical instrument if your arm is painful.
- . In addition the use of an elbow band can be very helpful to protect the elbow joint whilst playing.
Tennis elbow is a painful elbow disorder that occurs in a particular part of the elbow. It is associated with jobs that require repeated or forceful movements of the fingers, wrist, and movements of the forearm that pulls your hand in a backward motion. Also it is most common in people between 35 and 55. Tennis Elbow is typically most painful where the tendons of the forearm muscle attach to the bony point on the outside of the elbow. It is a condition caused by trauma to the tendons at the lateral epicondyle of the upper arm and is the most common injury in patients seeking medical attention for elbow pain. The type of treatment prescribed will depend on several factors, including age, type of other medications being taken, overall health, medical history,and severity of pain. If your condition does not respond to treatments for tennis elbow your doctor may suggests further test to rule out the possibility of problems with the radial nerve before suggesting surgery. However don't allow him to prescribe a course of cortisone injections as a therapy for your condition.