Lateral Epicondylitis

Lateral epicondylitis is commonly known as “tennis elbow.” This condition is essentially tendonitis in the outside part of the elbow. Tendonitis is inflammation of a tendon. A tendon is a group of cord like fibers which attach a muscle to a bone. Tendons can become irritated either thorough overuse or trauma. With lateral epicondylitis this is usually from returning to sporting activities to fast and too vigorously. However, it may occur from excessive overuse such as the constant use of a drill or screwdriver. Trauma can also cause tendonitis. If the elbow is hit or struck, "tennis elbow" or lateral epicondylitis may result. Trigger points can maintain the painful cycle of tendonitis long after the initial injury has healed. Trigger points adaptively shorten the muscle which continues to pull on the painful tendon which continues the inflammatory cycle.

Symptoms:

Pain is the primary symptom. It will be located at the outside part of the elbow, either on the bone or in the muscle areas above and below that bony area. Pain usually begins slowly and increases over several weeks. The discomfort is commonly described as hot or burning and the areas may actually feel warm or be red. Swelling may also be present. Taut rope like bands may be present as well. In more severe cases, the pain may be present at all times and begin to expand away from the area of initial pain. If the tendonitis has not become excessive, pain may be felt only during use.

Activities that are problematic are usually associated with extending the wrist, turning the palm upward, or straightening the elbow. But in severe cases, any movement of the wrist and elbow may be difficult.

Treatment:

Treatment depends on the severity of the inflammation. Rest is a primary consideration. Since the tendon attaches directly to the muscle, use of the muscle places stress on the tendon, which will continue to irritate the tendon. A splint may be issued to temporarily immobilize the affected area and prevent use of the muscle. Your physician may prescribe anti-inflammatory medications.

Physical therapy treatment may include manual and manipulative therapy to the elbow joint, therapeutic modalities such as low level laser therapy, iontophoresis, ultrasound, electrical stimulation, heat, or ice. These are all meant to decrease pain and localized inflammation. There are also therapeutic exercises and stretches which may speed recovery. It is important to follow the guidelines for the rest and exercise, because tendonitis can become inflamed again very easily. If you have had multiple episodes of tendinitis in the same area over several years, you may find it takes longer to heal. Also, in some cases, a procedure known as friction massage may be utilized.

If symptoms persist for a long time, deep and superficial dry needling may be indicated. Consult us at Bluegrass Doctors of Physical Therapy, PLLC