Diagnosis

In order to make a diagnosis, a comprehensive anamnesis is important first. Here the doctor should ask very precisely about the existing pain. This includes information about the type, frequency and localization of the pain, when it preferentially occurs, how long it lasts, whether it can be improved or worsened by certain activities, etc.

It is helpful for this purpose if the patient brings a pain diary to the doctor’s visit, in which he has noted down these points over several days. This is especially important because there are various diseases that are associated with pain similar to that of a tennis elbow, including the golfer’s arm, supinatorlogen syndrome, but also other inflammations or a tumor. However, the exact pain characteristics differ.

In addition, various tests can be performed: In the resistance test, the affected person must press his fist up or down against resistance, and when pressure is applied to the respective tendon insertions, the pain should increase, as should the rotation of the forearm or the extension of the middle finger.Especially in order to distinguish the tennis elbow from other diseases, such as the golfer’s elbow, but also arthrosis, it may be necessary to take an ultrasound or X-ray image. However, X-rays show characteristic changes only relatively late in the course of the disease. Within the scope of the therapy of tennis elbow, various measures can be taken, which should be based on the severity of the disease, the individual level of suffering and the wishes of the patient.

As a rule, a conservative therapy is started. This means that the first step is to try to treat tennis elbow without surgery. It is particularly important to spare the affected arm.

Of course, the very movement that caused the symptoms should be avoided, but other strains on the arm should also be avoided as far as possible. Pain can be easily improved by the patient himself by means of cold or heat treatment, whereby the application of cold is particularly effective in the acute stage, whereas heat is particularly effective in the chronic stage. When cooling, care should be taken to ensure that the ice never comes into direct contact with the skin and that it is never cooled for more than 20 to 30 minutes at a time.

Physiotherapy can also be useful. This includes certain stretching exercises that relieve pain and promote the healing process, as well as some special massage techniques, for example the transverse massage of the muscles of the wrist, also called transverse friction. Treatment with locally applied ultrasound or microwaves can also reduce pain and can be used either alone or in combination with massage to increase blood flow to the muscles before massage.

Similar, more controversial techniques are electro and shock wave therapy. It is also possible to apply a specific bandage, also called “epicondylitis brace”. This is a bandage that usually has to be worn for several days and relieves the painful muscles and tendons.

Other bandages or tapes can also be used to improve the symptoms. It is also possible to apply a specific bandage, which is also called an “epicondylitis brace”. This is a bandage that usually has to be worn for several days and relieves the painful muscles and tendons.

Other bandages or tapes can also be used to improve the symptoms. The next step in the treatment process is medication. Here, too, the doctor is offered various options, which are more or less effective depending on the case and should definitely be discussed with the patient before starting treatment.

First of all, there are bandages impregnated with ointments containing anti-inflammatory substances, usually a cortisone preparation. Such preparations can also be taken orally as an alternative. There is also the possibility of applying a mixture of such anti-inflammatory and local anaesthetics to the affected muscle attachment.

The anaesthetic is injected around the nerves, which causes a blockage of the nerve conduction and no more pain is felt. In addition, classical painkillers are of course also used, especially from the circle of antirheumatic drugs (antiphlogistics). Alternatively however likewise some vegetable preparations, enzymes, nucleotides or medicines can be used for muscle relaxation.

In some cases, acupuncture for the tennis elbow also seems to be helpful, as it can not only reduce the pain, but is also directly directed against the inflammatory reaction. As one of the last measures, a patient with tennis elbow can be given a forearm plaster splint, which must be worn permanently and should prevent any movement in the joint. However, this is already a considerable restriction for everyday life and therefore not a permanent solution.

If all of the above mentioned treatments do not improve the symptoms within 6 months, or if they even worsen under the therapy, there may be an indication for surgery. This is only done in individual cases and must be carefully considered. Surgery can normally be performed on an outpatient basis and has good chances of recovery.

Depending on the surgical technique, either the affected musculature is detached from its origin or the nerves supplying the area in question are sclerosed.Both can also be performed together in a single procedure. A new option is minimally invasive surgery, which requires only a very small skin incision, takes only a few minutes and the risks are minimal. However, this technique is still quite new and is not yet offered in many medical practices.

After this mini-operation, the patient is immediately mobile again. According to the standard procedures, a cast must be worn for a certain period of time and the arm is then slowly returned to its normal position. Under certain circumstances, postoperative physiotherapy may also be useful.

In general, the therapy of tennis elbow shows very good success rates and patients are able to move again without restrictions if they conscientiously take measures to prevent a relapse afterwards. But not only cold can help – microwave therapy generates heat and is also often used to treat the tennis elbow. Microwave therapy is an electrotherapy that uses electromagnetic waves to generate heat in the affected muscles or tissue, thus relieving pain, relaxing and increasing the metabolism.

Exercises with a Thera-band, a flexible rubber stick or vibration training with a fitness stick are increasingly used in physiotherapy. In addition, functional muscle building plays an important role. Another approach of sports physiotherapy is to stop using the wrong techniques and to optimize the general conditions.

Thus, incorrect warming up or stretching can also be reasons for the development of a tennis elbow. As a physiotherapist, one should give the person concerned instructions on how to perform stretching exercises correctly. Afterwards the stretching exercises can be carried out independently in everyday life.

In addition to the various treatment options of physiotherapy, an ointment dressing with cortisone can be helpful to reduce the inflammation in the tennis elbow. Acupuncture is also being used more and more often to treat a tennis elbow. The possibilities and forms of physiotherapy for tennis elbow are very extensive, which is why we have dedicated an entire topic to this form of therapy for tennis elbow. You can find more information under: Physiotherapy for tennis elbow