Chiropractic and elbow pain - tennis elbow problems (lateral epicondylitis)The term 'Tennis elbow' is commonly used to describe elbow pain found on the outer (lateral) aspect of the elbow and the upper part of the forearm. Most commonly the pain is due to tendonitis or inflammation of the tendon as it inserts into the bone on the outer lateral part of the elbow. Tendons attach muscles to the bone and typically have a poorer blood supply than muscles. It can also be the result of degeneration or periostitis at the muscle bone junction.
Common Signs and Symptoms of Elbow PainThe most common area for elbow pain in patients suffering with tennis elbow is on the outside elbow, which may radiate or travel either further up or down the arm. There may also be an associated loss of strength and weakness in wrist movement such as when lifting and gripping. This is because these movements are controlled by the muscles in the forearm.
Often there is exquisite and severe tenderness to palpation over the lateral aspect (outside) of the elbow. There may be pain experienced when using the wrist and hand, lifting or bending the arm or the patient may experience difficulty fully extending the forearm . Typically tendons have a poorer blood supply than muscles and therefore often inflammation in a tendon (tendonitis) will take longer to heal. If left untreated pain and inflammation can become chronic and can last for 6 to 12 weeks. Discomfort can continue for as little as 3 weeks or as long as several years.
If you suffer with shoulder pain and would like to find out how a chiropractic can help you then call 0207 000 1728 to make an appointment now.
Causes of Elbow Pain
Typically tennis elbow is a repetitive strain injury often the result of overuse. Any repetitive, forceful movements of the wrist, such as typing or playing tennis can cause shortening of the muscles. This causes the attachment of the muscles at the outer part of the elbow to be placed under considerable tension and a sudden movement at the wrist may cause a tear in the muscle or tendon such as the backhand swing in tennis. Often the injury may not be caused by actually playing tennis.
It is though that only a small percentage of those patients who are diagnosed as suffering from tennis elbow are actually tennis players. Other common causes include DIY and gardening or repetitive work at a desk/ computer, carpentry, plumbing, cashier work, bowling. It may also be associated with shoulder girdle dysfunction.
Assessment of Elbow PainYour back to health chiropractor will begin by conducting a thorough history of what exactly has caused the injury. This will include questions on the exact location of the pain, exacerbating and relieving factors, causes, types of pain, referral of pain, family history etc. Usually there is a history of gradual onset of intermittent pain.
You will then be offered an in depth physical examination which will look at all of the following factors:
- General posture and flexibility
- Specific orthopaedic tests to the arm, shoulder and the neck
- Joint play assessment of the shoulder
- Muscle tests to determine the extent of weakness
- Neurological assessment if required
- Xrays of the arm and or spine may be conducted depending on the extent of your problems and the examination findings.
Treatment of Elbow Pain
It is important to understand that tennis elbow typically takes 4 - 6 weeks to resolve and the results with conservative treatment measures are extremely good. Sometimes the condition can be slow to respond so remember to persist and don't get discouraged. 1) The initial aim of treatment is to reduce the local inflammation around the elbow
- Rest: Until the pain subsides use relative (not absolute) rest and avoid any activities that will aggravate the condition.
- Cryotherapy ( Ice): The use of ice is very effective in the first 2 to 3 days, although it is sometimes used for a longer period.
- Compression: Occasionally an elbow brace or an elbow strap may be needed, particularly if the problem persists.
- Adjust and mobilise the elbow and other involved structures including the shoulder and the spine.
- Gentle Soft tissue therapy (gentle drainage techniques).
- Adjust and mobilise the elbow and other involved structures including the shoulder, neck and spine.
- Vigorous soft tissue therapy (active release therapy) followed by cryotherapy (ice) to the muscle and the tendon.
- Home exercises including stretches and exercise to the involved structures.
- Lifestyle modification to eliminate aggravating the injury.
- It is very important that once the condition is resolved the patient and the chiropractor work to prevent recurrence of the condition. Often the condition may have nothing to do with playing tennis. In these cases understanding what has caused the condition is imperative.
- If the injury is indeed the result of tennis then they usually occur either at the beginning of a game of tennis (as a result of poor warm up techniques) or at the end of a game (when people are fatigued).
- Always warm up and stretch muscles before exercising and cool down.
- If the tennis elbow is the result of repetitive strain in the workplace then it would be appropriate to consider a work station assessment.
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