Lateral epicondylitis or tennis elbow is one of the most common lesions of the upper extremity. The incidence of this injury is 1% per 1000 patients per year and affects 1–3% of adults each year. It is an overuse injury that causes inflammation, tendinosis of the Extensor Carpi Radialis Brevis (ECRB) and lateral elbow pain at the origin of the ECRB tendon. Extensor Digitorum Communis (EDC) and Extensor Carpi Radialis Longus (ECRL) can also be involved.
Symptoms of Tennis elbow
The most common symptom of tennis elbow is pain on the outer part of the elbow. The pain may be localised or may radiate from the outside of the elbow into your wrist and forearm. The pain may be exacerbated by or make it difficult to:
• Make a fist or grip an object.
• Lift something, especially palm down.
• Shake hands or open the door.
• Raise your hand or straighten your wrist.
Other symptoms of tennis elbow include stiffness and weakness.
Treating Tennis Elbow
Although the diagnosis of tennis elbow is simple and easy, its treatment and management can be a little complex. In addition, the condition is prone to recurrence with high recurrence rates of 72% in the first year of injury and its symptoms may last for several weeks or months.
Different treatments have been suggested and used for tennis elbow. Conservative treatment options for the condition include applying ice, rest, physiotherapy (including tennis elbow brace, stretching, strengthening, dry needling along and shockwave), pain relieving and nonsteroidal anti-inflammatory drugs, and corticosteroid injection. Surgical options such as open, percutaneous and arthroscopic techniques can be used to treat refractory cases of lateral epicondylitis.
All these medical and physiotherapeutic interventions are aimed at reducing pain and improving functional status.
Shockwave Therapy for Treating Resistant Tennis Elbow
Radial pressure shockwave therapy is a relatively new modality for the treatment of tennis elbow. It is a non-invasive procedure and it involves passing shock waves through the skin to the lesion area using a special device. In the 1990s, the therapy was popular in Germany and was employed to manage certain soft-tissue disorders including plantar fasciitis, humeral epicondylitis and calcifying tendonitis of the rotator cuff. Today, it is used worldwide to treat a variety of musculoskeletal conditions.
The high energy acoustic waves promote regeneration and reparative processes of the soft tissues, inducing tissue repair, enhancing microvascular growth and thus relieving the symptoms of tennis elbow.
The medical practitioner may use ultrasound to ensure the device is in the right place on the elbow. The therapy can be performed in one or more sessions.
Effectiveness of Shockwave therapy in Tennis Elbow Treatment
Radial pressure shockwave therapy’s effectiveness in managing tennis elbow has been evaluated in several studies but conclusions have not been drawn because of the small numbers of studies conducted. However, it seems to be effective and has a longer therapeutic effect when compared to other conventional methods of treating tennis elbow.
According to a study published in Cochrane journal, shockwave therapy has been shown to ease pain, improve function and strength when compared to other forms of therapy.
There are risks and complications that may arise from radial shockwave therapy if it is not carried out by an experienced practitioner. The team at Turramurra Sports & Spinal Physiotherapy are trusted, local experts in shockwave therapy and will guide you in your treatment options to relieve pain. Give them a call on 02 9144 1510.