Discussion
For the last few months I've been having aches pains in my right elbow, I'd put this down to exercise/gym following lockdowns but the pain persists and I've not done any arm work since the end of November.
A quick google suggests tennis elbow and on the face of it it's just rest and can take up to 2 years depending upon the severity.
Does anyone have any experience of tennis elbow and what treatments are available and worked?
A quick google suggests tennis elbow and on the face of it it's just rest and can take up to 2 years depending upon the severity.
Does anyone have any experience of tennis elbow and what treatments are available and worked?
Evidence: https://www.cochrane.org/search/site/tennis%20elbo...
Conclusions:
Surgery: Due to a small number of studies, large heterogeneity in interventions across trials, small sample sizes and poor reporting of outcomes, there was insufficient evidence to support or refute the effectiveness of surgery for lateral elbow pain. Further well-designed randomised controlled trials and development of standard outcome measures are needed.
Orthotic devices (CLasps, braces, rollers etc) : No definitive conclusions can be drawn concerning effectiveness of orthotic devices for lateral epicondylitis. More well-designed and well-conducted RCTs of sufficient power are warranted.
Non Steroidal Medicines: There remains limited evidence from which to draw firm conclusions about the benefits or harms of topical or oral NSAIDs in treating lateral elbow pain. Although data from five placebo-controlled trials suggest that topical NSAIDs may be beneficial in improving pain (for up to 4 weeks), non-normal distribution of data and other methodological issues precluded firm conclusions. Some people may expect a mild transient skin rash. Evidence about the benefits of oral NSAIDs has been conflicting, although oral NSAID use may result in gastrointestinal adverse effects in some people. No direct comparisons between oral and topical NSAIDs were available. Some trials demonstrated greater benefit from glucocorticoid injection than from NSAIDs in the short term, but this was not apparent in all studies and was not apparent by 6 months in the only study that included longer-term outcomes.
Shockwave therapy: Based upon systematic review of nine placebo-controlled trials involving 1006 participants, there is "Platinum" level evidence that shock wave therapy provides little or no benefit in terms of pain and function in lateral elbow pain. There is "Silver" level evidence based upon one trial involving 93 participants that steroid injection may be more effective than ESWT.
Accupuncture: There is insufficient evidence to either support or refute the use of acupuncture (either needle or laser) in the treatment of lateral elbow pain. This review has demonstrated needle acupuncture to be of short term benefit with respect to pain, but this finding is based on the results of 2 small trials, the results of which were not able to be combined in meta-analysis. No benefit lasting more than 24 hours following treatment has been demonstrated. No trial assessed or commented on potential adverse effect. Further trials, utilising appropriate methods and adequate sample sizes, are needed before conclusions can be drawn regarding the effect of acupuncture on tennis elbow.
Deep massage: We do not have sufficient evidence to determine the effects of deep transverse friction on pain, improvement in grip strength, and functional status for patients with lateral elbow tendinitis or knee tendinitis, as no evidence of clinically important benefits was found. The confidence intervals of the estimate of effects overlapped the null value for deep transverse friction massage in combination with physical therapy compared with physical therapy alone in the treatment of lateral elbow tendinitis and knee tendinitis. These conclusions are limited by the small sample size of the included randomized controlled trials. Future trials, utilizing specific methods and adequate sample sizes, are needed before conclusions can be drawn regarding the specific effects of deep transverse friction massage on lateral elbow tendinitis.
Steroid injections: Despite the effectiveness of corticosteroid injections in the short term, non-corticosteroid injections might be of benefit for long-term treatment of lateral epicondylalgia. However, response to injection should not be generalised because of variation in effect between sites of tendinopathy. Ref: https://pubmed.ncbi.nlm.nih.gov/20970844/
Conclusion: Very little is proven to work, beyond stopping the activity that causes or aggravates it, and waiting.
Just because you do something to your arm whilst you wait, does not mean the thing you do is making any difference other than filling the time. You could just whistle.
Mine took 18 months to go away and ZERO squash/tennis in this time.
Conclusions:
Surgery: Due to a small number of studies, large heterogeneity in interventions across trials, small sample sizes and poor reporting of outcomes, there was insufficient evidence to support or refute the effectiveness of surgery for lateral elbow pain. Further well-designed randomised controlled trials and development of standard outcome measures are needed.
Orthotic devices (CLasps, braces, rollers etc) : No definitive conclusions can be drawn concerning effectiveness of orthotic devices for lateral epicondylitis. More well-designed and well-conducted RCTs of sufficient power are warranted.
Non Steroidal Medicines: There remains limited evidence from which to draw firm conclusions about the benefits or harms of topical or oral NSAIDs in treating lateral elbow pain. Although data from five placebo-controlled trials suggest that topical NSAIDs may be beneficial in improving pain (for up to 4 weeks), non-normal distribution of data and other methodological issues precluded firm conclusions. Some people may expect a mild transient skin rash. Evidence about the benefits of oral NSAIDs has been conflicting, although oral NSAID use may result in gastrointestinal adverse effects in some people. No direct comparisons between oral and topical NSAIDs were available. Some trials demonstrated greater benefit from glucocorticoid injection than from NSAIDs in the short term, but this was not apparent in all studies and was not apparent by 6 months in the only study that included longer-term outcomes.
Shockwave therapy: Based upon systematic review of nine placebo-controlled trials involving 1006 participants, there is "Platinum" level evidence that shock wave therapy provides little or no benefit in terms of pain and function in lateral elbow pain. There is "Silver" level evidence based upon one trial involving 93 participants that steroid injection may be more effective than ESWT.
Accupuncture: There is insufficient evidence to either support or refute the use of acupuncture (either needle or laser) in the treatment of lateral elbow pain. This review has demonstrated needle acupuncture to be of short term benefit with respect to pain, but this finding is based on the results of 2 small trials, the results of which were not able to be combined in meta-analysis. No benefit lasting more than 24 hours following treatment has been demonstrated. No trial assessed or commented on potential adverse effect. Further trials, utilising appropriate methods and adequate sample sizes, are needed before conclusions can be drawn regarding the effect of acupuncture on tennis elbow.
Deep massage: We do not have sufficient evidence to determine the effects of deep transverse friction on pain, improvement in grip strength, and functional status for patients with lateral elbow tendinitis or knee tendinitis, as no evidence of clinically important benefits was found. The confidence intervals of the estimate of effects overlapped the null value for deep transverse friction massage in combination with physical therapy compared with physical therapy alone in the treatment of lateral elbow tendinitis and knee tendinitis. These conclusions are limited by the small sample size of the included randomized controlled trials. Future trials, utilizing specific methods and adequate sample sizes, are needed before conclusions can be drawn regarding the specific effects of deep transverse friction massage on lateral elbow tendinitis.
Steroid injections: Despite the effectiveness of corticosteroid injections in the short term, non-corticosteroid injections might be of benefit for long-term treatment of lateral epicondylalgia. However, response to injection should not be generalised because of variation in effect between sites of tendinopathy. Ref: https://pubmed.ncbi.nlm.nih.gov/20970844/
Conclusion: Very little is proven to work, beyond stopping the activity that causes or aggravates it, and waiting.
Just because you do something to your arm whilst you wait, does not mean the thing you do is making any difference other than filling the time. You could just whistle.
Mine took 18 months to go away and ZERO squash/tennis in this time.
As above there are no quick fixes I'm afraid. Rest and stopping whatever has caused it are absolutely essential.
That said and after a previous recommendation from here, I did have some success with one of these https://www.amazon.co.uk/TheraBand-Tendonitis-Resi... It wasn't an overnight miracle but my observation is that it did accelerate the healing when comparing my first bout of tennis elbow with the second (on the other elbow, a couple of years later). A small sample I know.
That said and after a previous recommendation from here, I did have some success with one of these https://www.amazon.co.uk/TheraBand-Tendonitis-Resi... It wasn't an overnight miracle but my observation is that it did accelerate the healing when comparing my first bout of tennis elbow with the second (on the other elbow, a couple of years later). A small sample I know.
I found some partial relief through accupuncture but it might have been the placebo effect of novelty. As The Doc says, nothing seems proven to make much difference other than time.
On a more positive note, and speaking as someone who has suffered in both elbows more than once, I've found recovery time to be much quicker than forecast once I've stopped doing things that exacerbate it.
On a more positive note, and speaking as someone who has suffered in both elbows more than once, I've found recovery time to be much quicker than forecast once I've stopped doing things that exacerbate it.
CharlesdeGaulle said:
, nothing seems proven to make much difference other than time.
Not proven, but I can absolutely assure you that within three weeks about 80% of the pain in my elbow had gone. The final, nagging bit of pain took a while longer to disappear totally but the relief after a few weeks was lovely.I had tennis elbow from weightlifting - weirdly in alternate elbows (I suspect the pain in one resulted in over-compensating with the other). Rest and easing off was the only way it fixed itself. I tried braces, cross-friction massage, hot/cold etc - to no avail. Sometimes the massage eased the pain a little but it always returned as soon as I loaded the joints.
popeyewhite said:
Not proven, but I can absolutely assure you that within three weeks about 80% of the pain in my elbow had gone. The final, nagging bit of pain took a while longer to disappear totally but the relief after a few weeks was lovely.
You cropped my reply a little unfortunately. I've also had success with wrist curls. I was making the point that for most people it's a combo and time remains a key factor. I've suffered with tennis and golfers elbow, sometimes in both elbows at the same time! 😠
I found using one of these was useful; https://rpmpower.com/product-category/nsd-powerbal...
I found using one of these was useful; https://rpmpower.com/product-category/nsd-powerbal...
I worked for Ocado last year as a last resort when my company went tits up in the pandemic, and this was the cause of my elbow issues. I am 52, seem a bit predisposed to joint issues having had both knees operated on. Having said this, I was fit and a marathon runner and weightlifter.
After 6 months of carrying shopping to the top floor of lifts I developed tennis elbow both sides. It was terrible, and I saw a physio for 6 months. Massage and excercises made no difference, nothing worked. They offered me Shockwave treatment but I thought it was hockum. At one point I couldn't change gear on the work automatic van without severe pain.
It is a funny injury, I found I could carry heavy shopping bags to the top floor of flats, but the next day couldn't move my arms. At night I couldn't sleep because my arms were frozen, or I woke in agony with frozen arms. Then I would recover a bit and go back work, and repeat. Typing this brings back the memories of how awful it was, and how much better it is now.
One elbow is still poor, at this point I don't think it will ever fully recover or may take years. I still can't lift heavy weights for prolonged periods without getting sore arms. And have ot
I could go back to my medical insurer and persue keyhole surgery, but I don't think this is going to work or may cause it to be worse.
I just wanted to add my tale, sorry it is not more positive and hopefully you will recover quickly
After 6 months of carrying shopping to the top floor of lifts I developed tennis elbow both sides. It was terrible, and I saw a physio for 6 months. Massage and excercises made no difference, nothing worked. They offered me Shockwave treatment but I thought it was hockum. At one point I couldn't change gear on the work automatic van without severe pain.
It is a funny injury, I found I could carry heavy shopping bags to the top floor of flats, but the next day couldn't move my arms. At night I couldn't sleep because my arms were frozen, or I woke in agony with frozen arms. Then I would recover a bit and go back work, and repeat. Typing this brings back the memories of how awful it was, and how much better it is now.
One elbow is still poor, at this point I don't think it will ever fully recover or may take years. I still can't lift heavy weights for prolonged periods without getting sore arms. And have ot
I could go back to my medical insurer and persue keyhole surgery, but I don't think this is going to work or may cause it to be worse.
I just wanted to add my tale, sorry it is not more positive and hopefully you will recover quickly
gregs656 said:
Theraband Flexbar.
Yep, this. Helped mine a lot.You do the ‘Tyler Twist’ with it:
https://youtu.be/gsKGbqA9aNo
I’ve had both tennis elbow and golfer’s elbow in both elbows despite doing neither of those activities. Months of rest and ibuprofen didn’t work at all. Steroid injections are frowned upon by GPs but worked brilliantly for me, just needed to persuade the doc first. After the first injection worked he remembered me when I went back with the next elbow problem. Hopefully he was less reluctant with the next person to visit him with the condition.
I was recently in hospital for a month and had access to the physioterrorists for another matter. I raised the tennis elbow problem and they gave some guidance. It worked for me and very quickly too. Give this a try you’ve nothing to lose.
They stressed not to over do it and if it hurts you should stop. Just try 6 repetitions a few times a day to start. Put your arm from elbow to fingers on a flat surface. All you need to do is raise your hand from the wrist you can after a while add some resistance using your other hand to add some weight.
They stressed not to over do it and if it hurts you should stop. Just try 6 repetitions a few times a day to start. Put your arm from elbow to fingers on a flat surface. All you need to do is raise your hand from the wrist you can after a while add some resistance using your other hand to add some weight.
elanfan said:
I was recently in hospital for a month and had access to the physioterrorists for another matter. I raised the tennis elbow problem and they gave some guidance. It worked for me and very quickly too. Give this a try you’ve nothing to lose.
They stressed not to over do it and if it hurts you should stop. Just try 6 repetitions a few times a day to start. Put your arm from elbow to fingers on a flat surface. All you need to do is raise your hand from the wrist you can after a while add some resistance using your other hand to add some weight.
Yes these are called eccentric wrist curls.They have worked for me and a number of other people I know, and others on here.They stressed not to over do it and if it hurts you should stop. Just try 6 repetitions a few times a day to start. Put your arm from elbow to fingers on a flat surface. All you need to do is raise your hand from the wrist you can after a while add some resistance using your other hand to add some weight.
chemistry said:
gregs656 said:
Theraband Flexbar.
Yep, this. Helped mine a lot.You do the ‘Tyler Twist’ with it:
https://youtu.be/gsKGbqA9aNo
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