Dr. Donald Ajlouni
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Symptoms

Patients often complain of severe, burning pain on the outside part of the elbow. In
most cases, the pain starts in a mild and slow fashion. It gradually worsens over weeks
or months. The pain can be made worse by pressing on the outside part of the elbow or
by gripping or lifting objects. Lifting even very light objects (such as a small book or a
cup of coffee) can lead to significant discomfort. In more severe cases, pain can occur
with simple motion of the elbow joint. Pain can radiate to the forearm.

To diagnose tennis elbow, tell the doctor your complete medical history. He or she will
perform a physical examination.

The doctor may press directly on the bony prominence on the outside part of the elbow
to see if it causes pain. The doctor may also ask you to lift the wrist or fingers against
pressure to see if that causes pain.

X-rays are usually not necessary. Rarely, MRI (magnetic resonance imaging) scans may
be used to show changes in the tendon at the site of attachment onto the bone.

















Treatment Options

In most cases, nonoperative treatment should be tried before surgery. Chiropractic can
help with pain relief as the main goal in the first phase of treatment. After an
evaluation, treatment consists of a combination of ultrasound, myofascial or
cross-friction massage, electrical stimulation, and ice. The doctor may tell you to stop
any activities that cause symptoms. You may need to apply ice to the outside part of
the elbow. You also may need to take acetaminophen or an anti-inflammatory
medication for pain relief.

A support brace can help diminish symptoms of tennis elbow. The doctor may want you
to use counterforce braces and wrist splints. These can reduce symptoms by resting the
muscles and tendons.

Symptoms should improve significantly within four weeks to six weeks. If not, the next
step is a corticosteroid injection around the outside of the elbow. This can be very
helpful in reducing pain. Corticosteroids are relatively safe medications. Most of their
side effects (i.e., further degeneration of the tendon and wasting of the fatty tissue
below the skin) occur after multiple injections. Avoid repeated injections (more than two
or three in a specific site).

After pain is relieved, the next phase of treatment starts. Modifying activities can help
make sure that symptoms do not come back. The doctor may want you to do physical
therapy. This may include stretching and range of motion exercises and gradual
strengthening of the affected muscles and tendons. Physical therapy can help complete
recovery and give you back a painless and normally functioning elbow. Nonoperative
treatment is successful in approximately 85 percent to 90 percent of patients with
tennis elbow.

Treatment Options: Surgical

Surgery is considered only in patients who have incapacitating pain that does not get
better after at least six months of nonoperative treatment.


THE  CHIROPRACTIC  LIFESTYLE

Chiropractors are experts in the care of the bones, nerves, muscles and connective
tissues that make up about 60% of your body. All of the joints in your body are part of
this musculo-skeletal system and its optimal function is necessary for overall good
health. Ask your Doctor of Chiropractic for more information about a care program that
may include specific spinal adjustments, exercise recommendations, nutritional advice
or other conservative methods of care based on your health history, age, current
condition and lifestyle.

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REFERENCES:

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November 2004, Information Provided by AAOS