Dear Dr. Caraotta,
I am a firefighter and developed right elbow pain about four weeks ago. Whenever I am more active with my arm, such as handling the fire hose and even lifting things around the house, the pain intensifies. Someone told me that this may be tennis elbow, so I bought a tennis elbow splint. This helps a little, but the pain is still quite bad when I am more active. Someone suggested that I see a orthopedic surgeon, but I do not want surgery. What exactly is tennis elbow and what do you suggest?

“Tennis elbow,” also called lateral epicondylitis, is a term used to describe soreness or pain on the outside (lateral) part of the elbow. You don’t have to play tennis to get this, but the term came into use because it can be a significant problem for some tennis players. Tennis elbow symptoms occur when there is damage to the end of the tendon that connects lower arm and hand muscles to the upper arm bone at the elbow. Tennis elbow is usually caused by repeated twisting hand, wrist, or forearm movements done during everyday activities, such as using a screwdriver or scissors, gardening, and various sports. The most typical symptoms of tennis elbow are as follows:

* Pain slowly increasing around the outside of the elbow. Less often, pain may develop suddenly.

* Pain is worse when shaking hands or squeezing objects.

* Pain is made worse by stabilizing or moving the wrist with force. Examples include lifting, using tools, or even handling simple utensils such as a toothbrush or knife and fork.

Although tennis elbow commonly affects tennis players, it also affects other athletes and people who participate in leisure or work activities that require repetitive arm, elbow and wrist movement. Examples include golfers, baseball players, bowlers, gardeners or landscapers, house or office cleaners (because of vacuuming, sweeping and scrubbing), carpenters, mechanics and assembly line workers. The type of treatment prescribed will depend on several factors, including age, type of other medications being taken, overall health, medical history and severity of pain. The goals of
treatment are to accomplish the following objectives.

* Reduce pain or inflammation

* Rest and avoid any activity that causes pain to the sore elbow

* Apply ice to the affected area

* Using physical therapy modalities such as ultrasound, electrical muscle stimulation and exercises.

* Getting elbow adjustments

* Chiropractic and Non-surgical Orthopedic rehabilitation to strengthen muscles and tendons around the injured elbow.

* Sometimes taking nonsteroidal anti inflammatory drugs such as ibuprofen can be helpful

* Avoiding any activity that aggravates the pain.

* Use of the proper equipment in sports and on the job

* Use of the proper technique in sports or on the job

* Use of a counter force brace, an elastic band that wraps around the forearm just below the injured elbow (tendon) to help relieve pain

Overall, 90 percent to 95 percent of patients who report to our office for Chiropractic and Non-surgical Orthopedic Rehabilitation for tennis elbow will recover well with the above treatment.