Tennis elbow, or lateral epicondylitis, is a painful condition that occurs when tendons that attach to the elbow become overloaded. While tennis elbow can be caused by a known traumatic event, it’s more likely the result of microtraumas spread out over time that can be difficult to identify. Because of this, symptoms can come on gradually, and a patient may delay seeking care until the pain and discomfort inhibits their ability to carry out their normal work or leisure activities. It’s important to point out that tennis elbow is NOT limited to tennis players, or even athletes. Rather, lateral epicondylitis can affect plumbers, carpenters, painters, butchers, or any job or hobby that requires a firm grip and fast repetitive use of the hand and arm.
When managing the lateral epicondylitis patient, the in-office visit will likely focus on the use of manual therapies. A systematic review and meta-analysis that included seven studies on the use of manual therapies to manage tennis elbow concluded, “There is compelling evidence that joint mobilizations have a positive effect on both pain and/or functional grip scores across all time frames compared to control groups in the management of LET [lateral elbow tendinopathy].”
As with many musculoskeletal conditions, the pain associated with tennis elbow can lead sufferers to alter their mechanics when performing some tasks, which can overstress adjacent parts of the body, such as the wrist. As such, treatment may also need to be applied to these areas, such as the wrist, for the patient to experience a satisfactory outcome. A March 2023 systematic review looked at findings from four studies and found that a three-week course of treatment for tennis elbow that included wrist manipulation provided superior results to other treatment options like ultrasound, laser, friction massage, and exercises. The authors concluded, “The evidence is convincing that wrist joint manipulations positively affect pain in the short term, compared to comparison groups in the management of lateral epicondylitis.”
Along with manual therapies, a doctor of chiropractic will recommend that patients perform at-home exercises, rest or modified activities, and ice application, when appropriate. A chiropractor may also prescribe a counter-force brace, commonly referred to as a tennis-elbow splint (or brace), that helps when a person can’t take time off work or wants to continue a sport. In addition to getting a proper fit, your doctor of chiropractic will provide advice on how and when to wear it.
With such a multimodal approach to help restore proper motion to the elbow and other joints in the upper extremity, the tennis elbow patient will likely experience a reduction in pain and disability in the short term and if they follow their doctor’s self-care instructions, they can lower their risk for a recurrent episode.