Tennis elbow & more

Elbow pain brings to mind the well known “tennis elbow”, a tight muscular pain on the outside of the elbow.  But just as sciatica is not the only pain down the leg, so tennis elbow is not the only cause of pain here.  And on the inside of the elbow we have the sister problem of “golfer’s elbow”!  

Why are tennis and golfer's elbow painful?

Both of these involve an increase in the tension on the tendons of certain muscles because those muscles have themselves been overloaded or overstrained.  In turn, the tendons pull harder on any structures to which they attach, including elbow ligaments & even the bone itself.  

We tend to think of bone as just something rather hard.  We forget that it has blood supply and nerves, and that the surface is pain sensitive and can even be pulled up from the harder layer beneath, sometimes resulting in a painful lump.

Case study 1 - tennis elbow (lateral epicondylitis)

A woman in her early fifties had burning pain in the outside of her elbow, which tests indicated to be due to tennis elbow. Previous physio treatment had helped, but the problem returned, no doubt not helped by clerical work at the bank where she worked.  Even squeezing clothes pegs open hurt, as did bending her hand backwards.

Six sessions later her elbow was much improved.  Clothes pegs were no problem, nor was there any more of the burning or stabbing pains she had complained of.  

Interestingly, close examination showed significant pain in other muscles not directly associated with tennis elbow, so treatment ranged well beyond just rubbing the painful part and giving a few exercises.

Both the above problems can be very tenacious and stubborn to recover in some cases.  In this respect they share some similarity with other tendon related pains such as achilles tendonitis because recovery rates can vary a lot from individual to individual.  And in these stubborn cases what works for one person will often not help the next!

Case study 2

A good friend of mine with a healthy military background and a good knowledge of physical rehab. had such a bad case of tennis elbow that he could barely shake someone’s hand or grasp and turn a door handle.  He tried everything including physio, rehab exercises, acupuncture and, dare I say it, even osteopathy, but to no avail.  

What did finally work in his case was a heavy dose of apitherapy – which means being stung by bees a few times in the elbow during a single & very painful treatment!

The result here was a very powerful inflammatory reaction to the stings. If you keep in mind that inflammation is part of the healing process then there is some logic to the treatment.  

Yet it seems that in these chronic cases where the problem persists month after month, although there is painful inflammation, it isn’t resulting in complete healing.

Other elbow problems

But there’s much more to the elbow than these two conditions. Muscle problems can come from simply being over-strained through heavy or very repetitive movements.  This might give pain in the same areas but be much simpler to treat and come right.

Some tight muscles around the elbow can also compress and irritate nerves feeding into the hand, resulting in tingling or numbness there.  Very heavy manual work or workouts involving the hand weights can create so much ‘bulking up’ of the forearm & internal pressure that the person starts to complain of pain along the forearm at the front, and pins and needles in the hand.

Best advice?

Don’t self diagnose.  Come in and get it done right AND treated at the same time.