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Tennis elbow is a painful condition at the outer forearm, just where forearm meets the arm. This condition is also known as tennis elbow. Lately due to new evidence this condition has been brought under the umbrella of OOS (Occupational Overuse Syndromes also known as repetitive strain injury (RSI) syndromes.
Tennis elbow pain is most often connected to the activity of the arm or a wrist such as opening a jar or a door. Pain could also be quite intense with burning quality.
Latest studies have revealed a widespread mechanical hypersensitivity in patients suffering with lateral epicondylitis. Studies show that the brains perception of mechanical input such as occurs with normal activities of daily living is heightened. Patients with tennis elbow have significantly higher pain levels to pressure or cold applied over the muscles of the forearm. This evidence supports a role of peripheral sensitization mechanisms in the initiation of this syndrome.
There are three types of lateral epicondylitis:
Diagnosis is clinical.
Could be confirmed
by diagnostic ultrasonography.
Following conditions could mimic tennis elbow:
Postural support of the spine, shoulder and neck plays a key role in distribution of forces throughout elbow and forearm. In other words, inadequate support of the neck and shoulder blades on the spine causes further peripheral imbalance into muscles traveling across multiple joints of shoulder, elbow and wrist. Scientific evidence and clinical experience shows us that recovery time of treatment for wrist and elbow syndromes are much abbreviated when stability of shoulder blades is addressed.
Wrist mobility. Wrist and finger mobility is one of the most important factors in formation of stress to the lateral elbow.
Tissue texture quality plays an important role in development of musculoskeletal conditions of upper extremities. Women are usually more affected with painful syndromes of wrist and elbow due to different hormonal profile, which negatively affects tissue tensile quality.
Deficit in grip strength is a primary physical impairment in patients with tennis elbow. This deficit is predominately due to prior weakness and disruption of coordination to shoulder-elbow -wrist connection. Therefore pain is a result of consequences of this disruption to motor function. Therefore the mainstay of successful treatment of this condition is specific therapeutic exercise. There is significant evidence to support the role of isometric exercise in reducing pain, particularly in a ‘non-compressed’ position. There is also significant evidence (up to 76%) for treatment of chronic lateral elbow pain with Extracorporeal Shock Wave therapy.
For patients suffering from tennis elbow pain, we provide the most comprehensive approach. We use Dynamic Neuromuscular Stabilization (DNS), to restore alignment, mobility and stability at the elbow, wrist and shoulder. Our specialists also use many different types of fascial manipulation to improve motion control, allowing the myofascial tissue to lengthen and reduce stress to the muscles and tendons and their insertion to the bone at the lateral epicondyle. We also use acupuncture to eliminate active trigger points in the area of the forearm.
For patients suffering chronic severe pain or who have not responded well to conventional treatments, we may perform extracorporeal shockwave therapy (ESWT). Because shockwave therapy does not require a subcutaneous incision, it is non-invasive regenerative therapy. Low-intensity set of pressure and acoustic waves are used to stimulate metabolism and enhance the blood circulation in the affected area (neovasculogenesis). ESWT is a biological regenerative treatment that accelerates the healing process, gradually regenerating and restoring damaged tissue. Those hoping to treat elbow pain need look no further than the NYDNRehab.
Tennis elbow is marked by pain, burning and tenderness at the outside of the elbow, usually on the dominant arm. Inflamed tissue may feel warm to the touch. Pain may escalate when carrying objects with an extended elbow, or during rotating motions like opening a jar or turning a doorknob.
There are four subcategories of lateral epicondylitis:
Clinical diagnosis begins with a health history and physical exam. Diagnostic ultrasound may be used to confirm diagnosis and rule out other causes of elbow pain.
Some conditions that mimic tennis elbow include:
A 48 year old female writer presented at our clinic with pain in her lateral elbow. She had been diagnosed with lateral epicondylitis, and treated with steroid injections. When her symptoms were not resolved, she went to another practitioner who treated her elbow with extracorporeal shock wave therapy (ESWT) and five months of physical therapy. Nine months later, she was still in pain.
We used diagnostic ultrasonography to examine her elbow, and found no evidence of tendinosis at the lateral epicondyle, but we did discover a compression of the posterior interosseous nerve (PIN), which is a common mimicker of tennis elbow, and which is easily missed on MRI. Diagnostic ultrasound provides a clear image of the structures of the elbow in motion, in real time, offering precise insight into the nature and cause of the patient’s elbow pain. Early diagnosis with ultrasound can spare the patient ineffective conservative treatment approaches, and unnecessary surgery.
There are several risk factors that predispose a patient to tennis elbow:
Poor grip strength associated with disrupted coordination of the shoulder-elbow-wrist connection is a primary dysfunction of people with tennis elbow, which in turn leads to pain in the lateral epicondyle. Therapeutic exercise has long been the mainstay of treatment for severe elbow pain. Isometric exercise is sometimes effective in reducing pain when held in a non-compressed position. Extracorporeal shockwave therapy has been shown to have a high rate of success in treating lateral epicondylitis.
At NYDNR, we use a holistic and comprehensive approach to treat our patients with tennis elbow pain. After diagnosis using real-time ultrasound, we follow up with innovative therapeutic treatments, including:
For the best elbow pain treatment to help you heal quickly and improve your performance, contact NYDNR today. We are the very best clinic to treat tennis elbow in NYC.
