Tennis Elbow Treatment

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Tennis Elbow Treatment:

Initial treatment of tennis elbow usually involves self-care steps including rest, icing the area and use of acetaminophen (Tylenol, others) or over-the-counter anti-inflammatory medications, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others). These medications aren't recommended for long-term use because they can cause serious gastrointestinal problems.

If those steps don't help and you still have pain and limited motion, your doctor may suggest other steps. These may include:

    Analyzing the way you use your arm Your doctor may suggest that experts evaluate your tennis technique or job tasks to determine the best steps to reduce stress on your injured tissue. This may mean going to a two-handed backhand in tennis or taking ergonomic steps at work to ensure that your wrist and forearm movements don't continue to contribute to your symptoms. By keeping your wrist rigid during tennis strokes, lifting or weight training, you use the larger muscles in the upper arm, which are better able to handle loading stress.
    Exercises Your doctor or a physical therapist may suggest exercises to gradually stretch and strengthen your muscles, especially the muscles of your forearm. Once you've learned these exercises, you can do them at home or at work. Your doctor may also suggest you wear straps or braces to reduce stress on the injured tissue.
    Corticosteroids If your pain is severe and persistent, your doctor may suggest an injection of a corticosteroid medication. Corticosteroids are drugs that help to reduce pain, swelling and inflammation. Injectable corticosteroids rarely cause serious side effects. However, these medications don't provide a clear long-term benefit over physical therapy exercises or taking a wait-and-see approach and simply resting your arm. Your doctor may also suggest use of topical corticosteroids for pain relief. These corticosteroids are absorbed through your skin during a treatment called phonophoresis.
    Surgery If other approaches haven't relieved your pain and you've been faithful to your rehabilitation program, your doctor may suggest surgery. Your doctor will generally recommend surgery only if your arm movement is still restricted and you've tried other treatments for about a year. Only about one in 10 people with tennis elbow needs surgery.
    You'll be able to have the surgery done on an outpatient basis, meaning you can go home the same day. Surgery involves either trimming the inflamed tendon, or surgically releasing and then reattaching the tendon to relieve pain.
Other tennis elbow treatments are under investigation. Some treatments being studied include low-energy shock wave treatment, acupuncture, botulinum toxin, orthotic devices, such as braces or straps, and treatment with topical nitric oxide.

    Tennis Elbow Treatment . . . Prevention:
These steps may help you prevent a tennis elbow injury:

  • Review your technique Have a tennis professional review your technique to see if you're using the proper motion. Swing the racket with your whole arm and get your entire body involved in the stroke, not just your wrist. Keep your wrist rigid during ball contact. Also, make sure you have the proper racket grip size and string tension. Lower string tension of around 55 pounds transmits less force up to the elbow.
  • Build your strength Prepare for any sport season with appropriate preseason conditioning. Do strengthening exercises with a hand weight by flexing and extending your wrists. Letting the weight down slowly after extending your wrist is one way of building strength so that force is absorbed into your tissue.
  • Keep your wrist straight During any lifting activity — including weight training — or during tennis strokes, try to keep your wrist straight and rigid. Let the bigger, more powerful muscles of your upper arm do more of the work than your smaller forearm muscles do.
  • Warm up properly Gently stretch the forearm muscles at your wrist before and after use.
  • Use ice After heavy use of your arm, apply an ice pack or use ice massage. For ice massage, fill a sturdy paper or plastic foam cup with water and freeze it. Then, roll the ice directly on the outside of your elbow for five to seven minutes.

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      Tennis Elbow Treatment . . . What you can do
    Follow the instructions for P.R.I.C.E. — protection, rest, ice, compression, elevation:

  • Protection Protect your elbow from further injury by not using the joint. If a particular sport or work activity causes symptoms, you may have to stop the activity until your symptoms improve.
  • Rest Give your elbow a rest. But don't avoid all activity. Sometimes, wearing a forearm splint at night helps reduce morning symptoms.
  • Ice Use a cold pack, ice massage, slush bath or compression sleeve filled with cold water to limit swelling after an injury. Try to apply ice as soon as possible after the injury.
  • Compression Use an elastic wrap or bandage to compress the injured area.
  • Elevation Keep your elbow above heart level when possible to help prevent or limit swelling.

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