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Tennis Elbow: Sometimes Doing Nothing is Better
Posted on 12-06-2024 in Elbow by Dr. Steven Kronlage
Google tennis elbow or lateral epicondylitis, and you will find a thousand different treatment options for this condition. This proliferation of remedies tells us two things: lateral epicondylitis is a very common condition, and perhaps we don’t know how best to treat it!
Believe it or not--doing nothing truly seems to work better than doing anything!
There is no treatment for lateral epicondylitis that has been proven to work better than doing nothing. We, as patients, want to be out of pain and are willing to do things to get there. For this reason, there are thousands of remedies and treatments for tennis elbow. A recent study looked at 2300 patients treated non-operatively with a myriad of treatments, bracing, exercise, needling, tens units, and found no technique worked better than placebo. (Strauch, et. al COOR)
The only thing that has been proven NOT to work is a steroid injection. Steroids can increase the likelihood of failed non-operative treatment and the need for surgery.
Our main goal with patients is to get them pain-free function. Therefore, we believe that early-stage exercises are the way to go for lateral epicondylitis. In theory, by exercising the specific muscles affected, the parts of the muscle still attached to the elbow will strengthen. This will allow the “torn” and “degenerative” areas to heal.
We have great success early on treating lateral epicondylitis with an exercise program. Often, we will use a few supervised therapy visits to ensure that the patient is doing the exercises appropriately. Furthermore, we don’t believe that patients should stop activities because of lateral epicondylitis in order to allow it to heal. Exercising it before the activity to warm up the muscle will allow the patient to compete in whatever exercise or sport they want. It is, after all, a pain phenomenon.
In extreme cases, we do have surgical treatment, but it is typically reserved for longstanding symptoms lasting more than six to nine months. The good news is that surgery is almost always effective. During this procedure, the degenerative muscle will be removed, and the remaining tendon is sewn down to the bone.
Visit Tennis Elbow for additional information, including symptoms and diagnosis details.
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