What really works for tennis elbow pain

In over 10 years in chiropractic practice, one of the most common complaints experienced by the patients I treated was tennis elbow. And, I had the same advice for each person, rest the muscles, brace it, use ice, massage and give it four to six weeks.

Let me tell you, that was not popular advice since not many people are happy when they hear that the pain they’re in is going to last for a month or more. Yet, I had discovered through experience that for 99 percent of patients, no matter what else we tried, healing still took the same amount of time.

The truth is though that a large majority of the 200,000 people a year in the U.S. who suffer from tennis elbow get completely different advice when they see their medical doctor, who is likely to recommend treatments ranging from prescription anti-inflammatories to injection of Botox into the muscles.

Now, a new study is revealing the truth about the efficacy (or lack thereof) of these treatments…

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No relief but plenty of side effects

In the largest analysis to date, researchers at Beth Israel Deaconess Medical Center compared the efficacy and safety of 11 non-surgical treatment options for tennis elbow.  The meta-analysis, published in the American Journal of Sports Medicine, analyzed results from physical therapy, acupuncture, oral anti-inflammatory medications, local botulinum toxin (Botox) injection therapy, ultrasound, laser therapy and more.

The team combed through 36 placebo-controlled studies and the medical records of over 2,700 patients to analyze the treatments’ effects on pain and grip strength within a month of diagnosis, five and 26 weeks after diagnosis and more than 26 weeks after diagnosis.

According to Ara Nazarian, PhD, a principal investigator in the Center for Advanced Orthopedic Studies at BIDMC and Associate Professor of Orthopedic Surgery at Harvard Medical School, “All 11 treatment options provided only small pain relief, while increasing the odds of adverse events. More than 90 percent of the patients given placebo experienced pain resolution after four weeks.”

Okay, did you get that?

Every one of the treatment options resulted in only slight pain relief but significantly increased the risk of other problems (those dreaded side effects). While on the other hand, more than 90 percent of the people who were given a placebo (in other words the ones who didn’t get treatment) were fine after only four weeks.

And, that’s not all…

The team found that 99 percent of patients receiving only placebo reported little to no pain by 26 weeks after diagnosis.

And, in a head-to-head comparison across treatments, the team found that none of the treatment modalities demonstrated any significant benefit within four weeks of diagnosis.

They also discovered that patients who were given steroid shots complained of worse pain than patients receiving placebo. Not exactly what they signed up for I bet!

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Tennis elbow relief

According to the researchers, this proves that tennis elbow is a self-limiting condition – meaning, it will get better on its own if you give it time.

Here’s the advice I always gave my patients:

• Rest it – Tennis elbow is an overuse injury, so the more rest you can give it, the better. This means limiting the time you spend in the activity that caused it from sports and manual labor to time on the computer.
• Brace it – Braces to alleviate tennis elbow are easy to find both in stores and online and provide needed support while your elbow is healing.
• Use ice – Fill a Dixie cup with water and put it in the freezer. Peel back the top of the cup to reveal the ice and massage your elbow for 5 – 10 minutes. If it feels to cold on your bare skin, you can put a damp washcloth over your elbow and do the ice massage on top.
• Wait it out – Beyond that, all you can do is be patient and wait.

Tennis elbow will heal if you give it time. And, the study above proves that all those treatments your doctor offers do no good but could cause harm. So, use the tips above and give your elbow four to six weeks for the healing process to come to an end.

Source:

1. Tennis elbow treatments provide little to no benefit, study finds — Beth Israel Deaconess Medical Center