02 Feb Tennis Elbow and New Therapeutic Advances in Managing the Condition
Tennis elbow is the colloquial term given to the medical condition known as lateral epicondylitis. It is a painful condition that involves inflammation of the tendon that attaches the muscles of the forearm to the lateral epicondyle (outer bony aspect) of the elbow.
Causes and Risk Factors
Tennis elbow, as the name suggests, occurs in tennis players due to the way they grip and swing their rackets, especially during repeated use of the backhand swing with a poor technique. The repetitive motion of the wrist and forearm results in overuse of the tendon of the lateral epicondyle and this leads to inflammation of the tissue and small tears may develop in the tendon.
Other activities that may also lead to tennis elbow include:
- Using plumbing tools.
- Cutting up foods used for cooking, especially proteins such as red meat.
- Driving screws into walls.
- Repetitive use of a computer mouse.
The individuals who are at an increased risk of developing tennis elbow include:
- Those between the ages of 30 and 50, although the condition may occur at any age.
- Athletes or those who take part in racket sports such as tennis, squash, and badminton, especially if they incorporate poor or incorrect stroke techniques.
- Workers who are in occupations that require repetitive twisting motions of the forearm and wrist such as carpenters, electricians, and butchers.
Signs and Symptoms of the Condition
Individuals with tennis elbow have the following complaints:
- Pain over the outer aspect of the elbow that may spread or radiate to the forearm and wrist.
- Weakness of the arm.
- Decreased mobility and range of motion at the elbow. The patient may not be able to extend or flex the arm properly.
- Pain when performing activities such as turning a doorknob or shaking hands.
Conservative management of tennis elbow includes:
- Resting the affected limb.
- Applying an ice pack or cold compress over the affected joint every couple of hours for 5 to 10 minutes at a time.
- Using anti-inflammatory medication to help reduce the pain and swelling caused by the inflammation of the tendon.
- Physical therapy to help incorporate exercises in order to gradually stretch and strengthen the muscles of the forearm.
If these suggestions are ineffective then the following may be performed:
- Steroid and local anesthetic injections into the affected area may help to reduce the pain and inflammation at the lateral epicondyle.
- TENEX procedure where a needle is inserted into the injured tendon and ultrasonic energy is used to vibrate the needle to break up the damaged tissue so that it can be removed.
- Surgical intervention may be needed if the symptoms haven’t improved after 6 to 12 months of non-operative treatment.
A therapy that is becoming popular due to its efficacy and safety is the administration of stem cells to help repair the damage done to the tendon of the lateral epicondyle.
Stem cells are extracted from the patient’s own bone marrow and these cells are then injected into the affected area. There’s a positive response from the patient about 2 to 3 months after the initial injection.1
Musculoskeletal conditions are managed with specific stem cells known as mesenchymal stem cells (MSCs) and these have two specific functions:
- To stimulate anti-inflammatory proteins that help to reduce the inflammation causing damage to the tendon.
- Conversion of MSCs into cells of the tendon which then take the place of the damaged cells and repair the tissue.