Shockwave treatment for tennis elbow is a relatively new form of therapy in which gentle pressure waves are released into the skin around the lateral epicondyle, a bony protrusion of the outer elbow. When used in combination with conventional treatments such as elbow supports and pain relief exercises, shockwave treatment for tennis elbow has proven an effective treatment in the fight against lateral epicondylitis.
Bilateral elbow pain is a term used to describe any condition in which pain afflicts both elbows at the same time rather than just one. There are nearly 50 different conditions that can cause simultaneous burning elbow pain, among them bursitis, osteoarthritis, and lateral and medial epicondylitis (tennis elbow and golfer’s elbow, respectively). Because some of these conditions have similar symptoms, patients should consult their physician for a proper elbow pain diagnosis.
Bursae are sacs made of slippery tissue, lubricated with a small amount of fluid, that help reduce friction when skin, muscles, and tendons are sliding over bones. The olecranon bursa, which is located between the tip of the elbow (the olecranon) and the overlying skin, allows the elbow to bend and straighten.
When the olecranon bursa becomes irritated and inflamed, a patient develops elbow bursitis. This may occur because of a direct blow to the elbow that tears the blood vessel tissues that make up the bursa, causing the vessels to bleed into the bursa sac. When this happens, the bursa swells up like a balloon. The influx of blood into the bursa causes an inflammatory reaction, and the walls may remain thick and swollen even after the blood has been reabsorbed. This condition of thickness and swelling is the chief characteristic of olecranon bursitis.
However, olecranon bursitis may also develop more gradually. Individuals who are constantly resting their elbows on a hard surface may unknowingly be causing trauma to the elbow. Over time this may lead to irritation and swelling of the bursa. The olecranon bursa can also become infected, in which cause the bursa will fill up not with blood but with pus, causing the surrounding tissue to become warm and tender.
Elbow osteoarthritis is a condition involving degeneration of the articular cartilage in the elbow joints. Although this typically occurs over a period of many years, in some cases it can happen as a result of a bad sprain or fracture. Too much pressure placed on the cartilage surface may also bruise the cartilage.
Symptoms of elbow osteoarthritis may include pain and stiffness. Initially the pain only occurs during periods of intense activity. It may lessen in the rush of activity and increase during rest. Over time as the condition grows more severe, a patient may experience pain when at rest or asleep. There may be swelling and tightness around the elbow and an audible squeaking of the articular cartilage. Eventually the stiffness caused by osteoarthritis will limit the elbow’s range of motion, making it difficult for patients to straighten and bend their arms. Loss of motion will ultimately lead to loss of function.
Lateral epicondylitis (tennis elbow) is characterized by pain over the bone on the outside of the elbow, while medial epicondylitis (golfer’s elbow) is characterized by pain over the bone on the inner side. When the tendons attached to the lateral epicondyle become strained from overuse, they can deteriorate, resulting in damage to the extensor muscles in the forearm that are indispensable to gripping. In spite of its name, tennis elbow can result from a number of different factors, including repetitive arm motions in activities as varied as raking, rowing, painting, playing golf, and using a screwdriver. Symptoms include outside elbow pain, pain when swinging, tightness in the forearm muscles, and stiffness in the elbows.
When the tendons attached to the medial epicondyle become strained from overuse, golfer’s elbow may ensue. This happens as a result of excessive use of the flexor muscles in the forearm. Activities that contribute to golfer’s elbow may include improper golfing technique, advanced age, and repetitive arm motions in activities like hammering and golfing. Among the symptoms associated with golfer’s elbow are pain and tenderness on the inner side of the elbow, sometimes extending to the forearm; stiffness of the elbow; numbness or tingling in one or more fingers, and weakness of the hands and wrists.
Elbow pain exercises done under the supervision of a trained therapist can relieve elbow pains while increasing strength and flexibility.
Wrist extensor exercises are a form of elbow pain support for patients suffering from tennis elbow. These exercises can alleviate medial elbow pain by stretching the wrist muscles. In the wrist extensor stretch, a patient kneels on all fours and places her hands knuckle-side down with her fingers directed at her knees. Then, keeping her elbows straight and the backs of her hands on the floor, she leans forward until the heels of her feet touch her buttocks.
In the wrist flexor stretch, the patient begins in the same position, though with her palms to the floor and hands facing to the sides. Then, while carefully maintaining straight elbows, she leans backwards until her buttocks touch the heels of her feet. This is a great exercise for those suffering the effects of golf elbow on the lateral epicondylitis.
The hammer rotation is an exercise designed to improve circulation and lubricate the connective tissues in the elbow. Sitting in a chair and clenching an object like a hammer in her hands, the patient props up her forearm with her leg while hanging her wrist over her knee. Then, holding the hammer upright, she slowly turns it toward the left, then upright, then towards the right. This strengthening exercise is ideal for patients who are slowly re-acclimating themselves to their regular activities.
In the “bend and straighten” exercise, a patient bends his elbow back as far as it can go without feeling pain or excessive resistance. This can be repeated between 10 or 20 times in a sitting and should be done at least three times daily.
In the forearm rotation, the patient begins with his elbow at his side, bent to 90 degrees. He then turns his palm up and down as far as it can go without feeling pain. For best results this exercise, too, should be performed between 10 and 20 times.
The elbow extension and elbow flexion are advanced exercises designed to strengthen muscles. In the elbow extension, the patient uses one hand to straighten the elbow on the opposite arm. In the elbow flexion, he uses the other hand to bend the elbow on the opposite arm as far back as it can go.
When stretching the biceps and triceps, the patient should begin with back and neck straight. In the biceps stretch, his arm should be supported behind him on an accompanying table. Lowering his body, he allows his arm to move behind him until he feels a stretch. In the triceps stretch, he places one hand behind his lower neck and the other on his elbow. He then pushes his elbow backwards so that his hand moves down the back until he experiences a mild stretch. In both exercises, he should hold for 15 seconds and then repeat at least four times.
For best results, physical therapy should be undertaken in conjunction with physical treatments like icing and anti-inflammatory painkillers. Special elbow pain supports such as armbands or bandages may help support and protect the elbow until symptoms subside. Wrist splints may also lessen pain by resting the muscles that pull on the elbow. Wearing elbow supports in conjunction with physical therapy may ultimately provide better and more lasting pain relief.
Shockwave treatment for tennis elbow involves the use of pressure waves on the injured tissue. These waves pass through the skin, initiating a healing response that accelerates blood flow and the delivery of nutrients.
Depending on the severity of the injury, shockwave therapy for tennis elbow may employ either low-intensity or high-intensity shockwaves. Low-intensity waves may provide a slight sensation of discomfort, but are generally effective except in cases where the damage is severe. High-intensity shockwaves are considerably more painful and should only be taken in conjunction with some form of anesthesia. The advantage of high-intensity shockwaves, however, is that they are tremendously effective.
In a study reported in the American Journal of Sports Medicine in 2002, the long-term effects of shockwave therapy for tennis elbow were tested on 57 patients with lateral epicondylitis. In addition, a designated control group of six patients was unknowingly given a sham treatment. The study found that after one to two years of follow-up, 61 percent of patients receiving therapy were free of all complaints; 29.5 percent were significantly better; and one person was unchanged. The six members of the control group, on the other hand, reported significantly more pain and less range-of-motion. The study’s conclusion? “Shockwave therapy is a safe and effective therapy for the treatment of patients with lateral epicondylitis of the elbow.”
Patients seeking relief from burning elbow pain or bilateral elbow pain will find it at the New York DNR. Shockwave treatment for elbow pain is an innovative biological treatment that promotes self-tissue healing on a cellular level by activating the body’s own healing processes. The mechanical pulses we employ during shockwave treatment for elbow pain exert pressure and tension force on damaged cells, creating capillary micro-tears that promote new localized circulation and metabolism through the release of special enzymes known as “growth factors.” This results in the formation of new blood vessels that improve blood supply and oxygenation, accelerating the healing process in the elbow and relieving both unilateral and bilateral elbow pain.
Moreover, by modulating tissue plasticity, shockwave treatment for elbow pain remodels damaged tissues and breaks down deposits of calcium in the soft tissues, allowing a reabsorption of the calcium. Because excess calcium deposits in the soft tissue the root of many types of musculoskeletal pain, by breaking up these calcium deposits the pressurized waves relieve elbow pains and increase range of motion.
On top of all this, shockwave therapy for elbow pain stimulates bone cells that are responsible for healing and new bone growth, while simultaneously diminishing pain by stimulating the so-called “gait control mechanism.” The release of acoustic waves through the surface of the skin stimulates the healing process, effectively bringing elbow pain relief.
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