Pain & Technical Questions

Tennis Elbow

Q: I went to see a doctor because of an elbow pain, and I was told that it is a tennis elbow. 

A: If your elbow hurts when you hold an object, or you cannot open the lid of plastic bottle because of your elbow pain, it is highly likely that you have tennis elbow (medically known as lateral epicondylitis). Tennis elbow is a condition in which when the “lateral epicondyle of the humerus” becomes sensitive and painful when you do various activities such as sports or just spend time in daily life. 


The name “tennis” is included, but it does not necessarily happen only to tennis player. It can happen to golf player or fisher or even to those who have heavy loads. Also, it can occur when you hold a baby or even housewife who does not have any particular burden.   
Tennis elbow can easily be cured sometimes without any treatment, but unfortunately it is not uncommon, and time passes without getting any better. If symptoms do not improve, it is better to go to a professional medical institution. 

Q: Where does the tennis elbow cause pain?

A: The official name for tennis elbow is “humeral lateral epicondylitis.” The painful place where tennis elbow causes is the area called lateral epicondyle of the humerus. There is a bone protrusion at the front of the elbow when you fold arms, this is the part. Tennis elbow causes the pain in this bone protrusion or around it. 

Q: What causes tennis elbow? Why this occurs? 

A: The other cause is aging. The number of people who get tennis elbows rapidly increases from approximately age 45. There is a possibility to have tennis elbow even younger than that age, but it increases overwhelmingly after middle age. 


There is a reason. Tennis elbow is thought to be caused by increasing abnormal vessels in the bone protrusion of lateral epicondyle. 


These abnormal blood vessels are more likely to increase after middle age. In addition, not only blood vessels but also nerve fibers increase together and become the cause of pain. Abnormal vessels in elbow become “tennis elbow” and in shoulder become “stiff or frozen shoulder.” If you would like to know more about these abnormal vessels, please check the following article.

Q: It has been six months since I had a tennis elbow. Although I tried various treatments, but it does not get better. What is the reason? 

A: If the condition of tennis elbow is mild, it can be cured within a few weeks. However, if the condition is severe, it cannot be cured easily. 
If you have been treated but not cured, the treatment you have now may not approach the cause of pain properly. 
As mentioned in the previous article, the cause of tennis elbow is “abnormal vessels and nerves around them.” Without approaching this cause of pain, the pain cannot be cured. It has been already six months, there is a high possibility that your case is severe, we recommend you visit a professional medical clinic. 

Q: Please let me know if you have any stretches that work for tennis elbow.

A: Here are two stretches for tennis elbow. It may be a little painful at first but try to do 3 to 4 times a day for about 15 seconds at a time.

Stretch 1
Lift the painful hand forward to shoulder level. The elbow is extended with the palm facing down. With the opposite hand, hold the back of the painful hand downward. Then some of the muscles in your forearm will be stretched and you will feel the tension. Keep it for 15 seconds.

Stretch 2
Lift the painful hand forward to shoulder level. Place the palm of your hand facing upwards. Hold the fingertips of the painful hand downward with the opposite hand. Then some of the muscles in your forearm will be stretched and you will feel the tension. Keep the posture for 15 seconds. 

Q: I feel a pain inside of my elbow, is this a tennis elbow?

A: The symptom of tennis elbow occurs outside of the elbow. If you have pain on the inside of your elbow, the official name is “humeral medical epicondylitis” and is commonly referred to as “golf elbow.” However, just like tennis elbow, golf elbow does not necessarily only happen to people who play golf. 
In the case of inside pain, the proper stretches or treatment at a medical institution should be different. If you are having trouble getting well, please consult with a professional medical institution. 

Q: I am not sure if I should take an injection for tennis elbow. Will the injection work?

A: If you get an injection for tennis elbow, the effect will vary depending on the substance of injection and the place. Injections containing steroidal ingredients to painful places can have a short-term effect. However, in severe cases, the pain recurs, and some people take the injection repeatedly.
As steroidal ingredient will weaken the tissue, it is better to get the injection up to three times. To determine if your tennis elbow is severe, you should see a professional health care provider. 

Q: Is a poultice effective for tennis elbow?

A: In the case of tennis elbow, poultices are rarely effective. It is not that it does not work at all, but poultices cannot be a method of healing. Especially for patients who have severe cases, it is not expected to be effective. We recommend seeing a professional at a medical clinic.

Q: It has been six months since I got a tennis elbow, but it is getting worse. Is there anything in daily lives that could cause it to get worse? How I can prevent it from progressing? 

It has been six months since I got a tennis elbow, but it is getting worse. Is there anything in daily lives that could cause it to get worse? How I can prevent it from progressing? 


There are many factors that cause to be so severe. Tennis elbow is caused by repeated strains on the elbow, so the greater strains (like holding heavy objects, repeated exercise, etc.), the more likely it is to be severe. 
In order to make sure that it does not become as serious as possible, 


1. Avoid moving that can cause pain in the elbow
2. Try to improve your health
3. Do some self-exercises such as stretch or band which is good for tennis elbow

Q: Is it better to use taping or supporter for tennis elbow? Are there any other goods? 

The most recommended item is a band. The band is wrapped around the part of the forearm that is slightly closer to the hand than the elbow and lightly tightened. This band is more effective in improving tennis elbow compared to taping, supporters or any other methods.

Band
Why is the band so effective? It has a relationship with the “abnormal blood vessels” that are causing tennis elbow pain.

Q: I got a tennis elbow, and I tried rehabilitation and injection, but both did not work. What kinds of further treatments are available? 

In some severe cases which injection is not enough to heal, a special treatment called catheterization is available. It is a treatment that targets the abnormal blood vessels that cause tennis elbow pain. The purpose of this treatment is a complete cure. You can also read the article.
There is also another option of surgery with a scalpel, but the surgery involves cutting the tendon that causes the pain. This is a method of cutting and removing the tissue that originally existed, and it is true that the pain will be less than before the procedure. However, the pain may remain afterwards (after 2-3 years) or the discomfort may remain. We do not recommend it because you also need to be hospitalized.

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