Treating lateral epicondylitis

When spring is here and athletes get outside and increase their volume, some may develop a nagging, relentless pain in their lateral elbow that doesn’t seem to recover. After a few months of trying to deal with it they come seeking treatment and then they get the diagnosis of ‘tennis elbow’, the very mention of which will make anyone who has had it before cringe.

Like other tendonopathies, tennis elbow is characterized by a breakdown in the tendon tissue and not an inflammatory process. This means that the typical recommendation of ice and NSAID’s are unhelpful in resolving it. Unfortunately, so are other treatments. A lot of research has gone into the treatment of tendon injuries without much success. Exercise is better than no exercise, but doesn’t always work. Eccentric exercise is theorized to realign the collagen fibers and increase strength, but once again not always with success. Cortisone injections help alleviate pain in the short term, but there is not benefit long term and PRP or prolo therapy has had inconsistent results. At the end of the day, the pain usually self resolves regardless of what treatment has been tried.

There is not good data that discusses prevention, so if your elbow is starting to bother you; back down the intensity of your training. Use a strap for support if you need it and ice 10 min for pain relief. Keep exercising, but loosen your grip. If it continues to negatively affect your life it may be time to discuss a cortisone injection.