Thursday, September 3, 2009

Tennis Elbow Treatment

Tennis Elbow Treatment
There are several available treatments for tennis elbow. These usually start off conservatively and work up to more involved treatments. Non-surgical treatment is successful in over 90 percent of patients.
Lifestyle Modification
Lifestyle modification is important if tennis elbow does not resolve or if it recurs. With athletes, often an improvement in technique (see below) can resolve the problem.
Changing Stroke Mechanics & Racquet
Tennis racquets should be sized properly. Higher stringing tensions may contribute to tennis elbow. Playing on harder surfaces also increases the risk of developing tennis elbow. Stroke mechanics should be evaluated to ensure patients are hitting the ball in the center of the racquet; players should not lead the racquet with a flexed elbow. See a tennis pro/instructor for a swing and racquet evaluation.
Anti-inflammatory Medications Anti-inflammatory medications are often used to help control pain and inflammation. The oral forms of these medications are easy to take and often help control inflammation and manage pain.
Cortisone Injections
If these conservative measures fail, a steroid (cortisone) injection is a reasonable option. If a person has tried more than two cortisone injections without relief, it is unlikely that additional injections will benefit the patient.
Elbow Brace and Exercises
An elbow orthosis, called an elbow clasp, can be worn. The theory behind using an elbow clasp is that the brace will redirect the pull of misaligned muscles. Patients often find relief of pain when using the clasp during activities.
Some simple exercises can also be helpful in controlling the symptoms of tennis elbow. These exercises should not cause pain, and those that do should not be done until pain resolves. By strengthening the muscles and tendons involved with tennis elbow, you can help prevent the problem from returning.
Surgery
There are several possible surgical treatments that have been successful. These include removing a portion of the damaged tendon or releasing the attachment of the affected tendon. A repair of the healthy portion of tendon is sometimes carried out as well.
Surgery to release the damaged tendon is usually successful, but rarely needed; about 95 percent of patients with tennis elbow can be treated without surgery. A variety of conservation treatments should be tried prior to opting for surgery.
Possible New Treatments
Extracorporeal Shock Wave Therapy
Shockwave therapy is a controversial treatment option for tennis elbow. The idea behind shockwave therapy is to use sound waves to induce so-called 'microtrauma' to tissues. This microtrauma initiates a healing response and helps to decrease inflammation. Shockwave therapy is also used in the treatment of heel spurs and kneecap tendonitis.
Results of studies investigating this treatment have been mixed. There is no strong evidence that this is a better treatment than other conservative options. One of the better designed studies found there was no benefit from using shockwave therapy for tennis elbow. Some insurance companies will not pay for this treatment either.
Autologous Blood Injection
An article in the Journal of Hand Surgery reported the results of a small group of patients who underwent injection of their own blood into the location of lateral epicondylitis. The idea proposed by the authors is that the blood injection supplies the necessary healing components to help cure the problem.
The study fails to compare this treatment to more standard treatments, and the number of patients investigated is quite small. That said, the authors report good results. This may become a more standard treatment option, but more investigation is needed.

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