Lateral epicondylitis, aka tennis elbow, is a painful condition affecting the outer side of the elbow. Tennis elbow arises from repetitive overuse of the forearm muscles that bend your wrist backward, causing micro tears and inflammation in the tendons that attach muscles to bones at the elbow, and putting pressure on nerves. Because tendons have low vascularity, tennis elbow can take months to fully heal unless proactive measures are taken to accelerate the healing process.
Learn more about lateral epicondylitis, and how focal cryotherapy for tennis elbow can provide a fast and effective therapeutic solution.
Mechanics of the Forearm and Elbow
The forearm is made up of two long bones — the radius and the ulna — that run parallel to one another from the wrist to the elbow. The radius is located on the thumb side and is shorter and smaller than the ulna. The two bones are held together by an interosseous fascia membrane.
Deep fascia divides the forearm muscles into two compartments. The anterior (frontal) compartment contains the wrist flexors, and the posterior compartment contains the wrist extensors. Altogether, the forearm contains 19 muscles — 11 extensors and 8 flexors — responsible for flexion and extension of the wrist and fingers.
The hands and forearm are innervated by the radial nerve that descends from the upper arm, entering the forearm in front of the lateral epicondyle, the bony knob of the humerus.
The radial nerve divides into two branches at the radial tunnel — an area where the muscles overlap at the top of the forearm. The deep motor branch innervates the posterior compartment containing the wrist extensors, and the superficial sensory branch innervates the anterior compartment containing the wrist flexors. Compression of the radial nerve can occur if there is swelling or tightness in the tunnel, causing pain and weakness in the elbow and forearm.
During physical activity, forces applied at the wrist are distributed along the forearm to the elbow joint. In some cases, forces transmitted to the elbow can reach multiple times the person’s body weight. To offset outside forces while achieving mechanical efficiency, a combination of stability and mobility is required at the elbow.
Elbow stability depends on strong ligaments, muscles and tendons to hold everything in place. When applied forces exceed the capacity of those structures to provide stability, soft tissue injuries can arise in the muscles, tendons and nerves.
Causes and Symptoms of Tennis Elbow
During activities like racquet sports, large forces are applied at the wrist as the racquet strikes the ball, causing the wrist to bend backward. The muscles of the forearm work to stabilize the wrist to prevent hyperextension. In the process, forces are distributed along the forearm bones and muscles, causing the tendons to pull against their bony attachments at the elbow.
When forces are applied over and over again, tendon tissues can start to fray, causing pain and inflammation at the elbow. Pain may be intensified by compression of the posterior interosseous nerve inside the radial tunnel.
Approximately 50 percent of tennis players develop tennis elbow at some time in their life, with peak incidence occurring between the ages of 40 and 50. Tennis elbow can arise from incorrect form or muscle fatigue when playing tennis or other racquet sports. It can also be caused by other types of repetitive motions that overload the forearm muscles.
Symptoms of tennis elbow include:
- Pain and tenderness at the outer elbow
- Weakness in the forearm muscles
- Burning or pain in the elbow that travels to the wrist
- Pain when twisting or bending the arm
- Stiffness or pain when extending the arm
- Symptoms that worsen at night
Although tennis elbow is a common sports injury, it is also a frequent injury in occupations that overload the elbow by twisting motions, or motions that recruit the wrist extensors as stabilizers.
Occupations that frequently cause tennis elbow include:
- Dentistry
- Carpentry
- Painting
- Construction
- Plumbing
- Butchery
- Weight lifting
Low vascularity in the tendons of the forearm muscles cause tendon tissues to heal slowly, and tennis elbow symptoms can persist for months on enc. Continued overuse of the forearm muscles can further prolong healing. Taking a break from the activity that caused the condition is key to proper healing. However, when your livelihood depends on that activity, taking time to heal may not be an option.
How to Get Rid of Tennis Elbow
Activity modification is an important step in relieving tennis elbow symptoms. Continuing to do the activity that caused it can worsen the condition and prolong your pain. Over time, damaged tendon tissue can begin to degenerate, creating more complex problems that are harder to resolve.
In addition to activity modification, common treatments include:
- Medications to reduce inflammation
- Over-the-counter NSAIDs like ibuprofen or naproxen
- Corticosteroid injections to target inflammation
- Wearing a supportive brace
- Physical therapy
When those approaches fail to resolve your tennis elbow, surgery may be recommended as a last resort. Most surgical approaches involve detaching parts of the forearm muscles or separating and destroying the nerves that cause pain.
Elbow surgery for lateral epicondylitis can lead to dysfunction that limits your elbow mobility for life, taking you full cycle to the activity modification that was avoided early on. However, 80 to 95 percent of patients are able to resolve their tennis elbow pain without surgery,
Tennis Elbow and Cold Therapy
One of the fastest and most effective treatments for tennis elbow is focal cryotherapy, a non-invasive approach that directs a stream of icy-cold nitrogen gas to the site of injury via a hand-held wand.
Focal cryotherapy can dramatically shorten the duration of your symptoms and accelerate healing, so you can get back to your sport or occupation in record time.
Cryotherapy for Tennis Elbow in NYC
As a non-invasive treatment method, focal cryotherapy for tennis elbow does not require a doctor’s prescription. When performed by a trained clinician, spot cryotherapy is effective for tennis elbow and other soft tissue injuries.
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To take advantage of this quick and convenient solution to get rid of tennis elbow, contact InVita Wellness today.
Resources
Kamien, Max. “A rational management of tennis elbow.” Sports Medicine 9 (1990): 173-191.
