What Does The Research Say?
Tennis elbow has many medical names but what it really means is PAIN IN THE OUTER SIDE OF THE ELBOW. It hurts to grip, to push with the top of the hand, open jars, move the fingers and sometimes even to straighten the elbow.
Lateral elbow pain is common (1 to 3 percent of the population), mostly occurring at 40 to 50 years of age. In women between 42 to 46 years of age, it occurs closer to 10 percent of the time and is more likely to occur on the other side.
The causes can be from too much load on the elbow tendon to poor movement of the wrist, elbow or shoulder. Sometimes the neck can be the cause.
Generally, people with this can suffer for 18 months to two years with pain or dysfunction.
A large clinical trial that looked at multiple research papers concluded that:
1. AT 6 WEEKS: If you have an injection of cortisone at 6 weeks, you were much better than those doing therapy or waiting it out.
2. AT A YEAR: after a year, those who did physiotherapy or even complete rest (wait and see approach) were better than those who had a cortisone injection. Those having the injection flared up again.
3. AT A YEAR: Those having done physiotherapy were better than those waiting to see how they were doing. (Wait and See approach was worse off).
SO: WHAT DOES THIS MEAN??
1. Physiotherapy is no different than waiting it out – If you want to do NOTHING with that
arm and hand over the next few months until it gets better.
2. Many of us don’t have the luxury (or patience) to do nothing to see how things will turn out.
Physiotherapists are trained to identify the necessary areas to target and treat as well as
give “active rest” advice to help clients move forward faster and with some form of activity.
WHAT DOES THE PHYSIOTHERAPIST DO?
Here are research-based treatment approaches that are done by the Therapists at Sheddon Physiotherapy and Sports Clinic.
ACUPUNCTURE (FOR SHORT-TERM PAIN RELIEF)
Small trials show evidence that needle acupuncture, laser acupuncture, and electroacupuncture in persons with tennis elbow can help with acute pain in Tennis Elbow when compared to a placebo.
EXERCISE AND MOBILIZATION
Trials have found that exercise improved pain and function after treatment and at 11 months compared with placebo.
One trial found that exercise improved pain at six to eight weeks compared with ultrasound plus friction massage.
TENNIS ELBOW BRACE
On their own, research has shown that, at 6 weeks, the brace was less effective than physical therapy at improving pain outcomes or subjective satisfaction but more effective at improving functional ability. (so it helps, just not as much as your physio).
What we don’t do…(what doesn’t work)
EXTRACORPOREAL SHOCK WAVE THERAPY (high pulsed ultrasound)
Often considered in the medical field to be more a marketing tool, this expensive treatment has had a lot of research of late. A review of 9 research papers found no significant difference in pain outcomes between shock wave therapy and placebo.
DON”T DELAY IN TREATMENT. CALL US TODAY (905-849-4576) or Click Here To Book Your Appointment Today.
1. Lancet. 2002 Feb 23;359(9307):657-62. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial.
2. Am Fam Physician. 2007 Mar 1;75(5):701-702.