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Tennis Elbow Treatment Options

Posted Oct 23 2009 10:04pm

I often get asked by our patients if there is anything we can do for tennis elbow, shoulder bursitis, or other inflammatory joint conditions. My answer has always been, “Not only can I do something for it, but manipulation and therapy is often the primary recommended treatment.” Over the past several years, there has been an increasing amount of published research documenting superior results and more successful outcomes with chiropractic care when compared to traditional medications or rest. This is not to say that medications or coordination with your medical doctor is unnecessary, but it does mean that chiropractic is often the first method of treatment that should be chosen.

With regards to tennis elbow, a study published in the British Medical Journal by Australian researchers documented that manipulation with exercise gave superior advantages over a “wait-and-see” approach, and also gave better long-term results than corticosteroid injections. There were relatively little improvements at six weeks with the “wait-and-see” group. In the injection group, and in the manipulation and exercise group, both treatment methods effectively relieved the symptoms at six weeks. However, in the corticosteroid injection group, the symptoms returned in 72% of the cases. Not so with either of the other two groups.

In fact, the article states, “Recurrence rates were higher and recovery delayed in the mid to long term after corticosteroid injection compared with physiotherapy or wait and see.” Also noted was the fact that “patients who received [manipulation of the elbow and exercise] sought significantly less other treatment.” In other words, not only was manipulation and exercise better for patients in the long run, but those patients also did not have to resort to home remedies, over-the-counter meds, or other more invasive treatment techniques as often.

Other research has shown possibly even more promising outcomes when using acupuncture for the treatment of tennis elbow. The effectiveness of acupuncture in treating tennis elbow was the subject of a study done in Sweden by Dr. Gunilla Brattberg.  She found that patients treated with acupuncture became much better, or even completely free of pain.  None of them got worse or had any side effects from acupuncture treatment.  Dr. Brattberg noted that acupuncture is a more time-consuming treatment modality than steroid injection, but while there may be dramatic improvement using steroids, there can also be a worsening of symptoms with steroids.  Most acupuncture practitioners find that patients who have had steroid injections are slower to respond to acupuncture treatments than patients who have not been injected.

If you or someone you know has tennis elbow, please take the time to research your options before jumping in for the quick and easy fix. Unfortunately, most research shows traditional Western medicine options to be not so quick, not so easy,… and most of the time, temporary.

References:

1. Bisset L, Beller E, Jull G, et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ (online first), Sept. 29, 2006.

2. Dorsher PT. Treatment of chronic lateral epicondylitis with acupuncture: a pilot study. Presented at the annual meeting of the American Academy of Physical Medicine and Rehabilitation, San Francisco, CA, November 4, 2000.

3. Norton A. Acupuncture serves up cure for tennis elbow. Reuters Health, November 6, 2000.

4. Brattberg G. Acupuncture therapy for tennis elbow. Pain 1983;16:285-288

I often get asked by our patients if there is anything we can do for tennis elbow, shoulder bursitis, or other inflammatory joint conditions. My answer has always been, “Not only can I do something for it, but manipulation and therapy is often the primary recommended treatment.” Over the past several years, there has been an increasing amount of published research documenting superior results and more successful outcomes with chiropractic care when compared to traditional medications or rest. This is not to say that medications or coordination with your medical doctor is unnecessary, but it does mean that chiropractic is often the first method of treatment that should be chosen.

With regards to tennis elbow, a study published in the British Medical Journal by Australian researchers documented that manipulation with exercise gave superior advantages over a “wait-and-see” approach, and also gave better long-term results than corticosteroid injections. There were relatively little improvements at six weeks with the “wait-and-see” group. In the injection group, and in the manipulation and exercise group, both treatment methods effectively relieved the symptoms at six weeks. However, in the corticosteroid injection group, the symptoms returned in 72% of the cases. Not so with either of the other two groups.

In fact, the article states, “Recurrence rates were higher and recovery delayed in the mid to long term after corticosteroid injection compared with physiotherapy or wait and see.” Also noted was the fact that “patients who received [manipulation of the elbow and exercise] sought significantly less other treatment.” In other words, not only was manipulation and exercise better for patients in the long run, but those patients also did not have to resort to home remedies, over-the-counter meds, or other more invasive treatment techniques as often.

Other research has shown possibly even more promising outcomes when using acupuncture for the treatment of tennis elbow. The effectiveness of acupuncture in treating tennis elbow was the subject of a study done in Sweden by Dr. Gunilla Brattberg.  She found that patients treated with acupuncture became much better, or even completely free of pain.  None of them got worse or had any side effects from acupuncture treatment.  Dr. Brattberg noted that acupuncture is a more time-consuming treatment modality than steroid injection, but while there may be dramatic improvement using steroids, there can also be a worsening of symptoms with steroids.  Most acupuncture practitioners find that patients who have had steroid injections are slower to respond to acupuncture treatments than patients who have not been injected.

If you or someone you know has tennis elbow, please take the time to research your options before jumping in for the quick and easy fix. Unfortunately, most research shows traditional Western medicine options to be not so quick, not so easy,… and most of the time, temporary.

References:

1. Bisset L, Beller E, Jull G, et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ (online first), Sept. 29, 2006.

2. Dorsher PT. Treatment of chronic lateral epicondylitis with acupuncture: a pilot study. Presented at the annual meeting of the American Academy of Physical Medicine and Rehabilitation, San Francisco, CA, November 4, 2000.

3. Norton A. Acupuncture serves up cure for tennis elbow. Reuters Health, November 6, 2000.

4. Brattberg G. Acupuncture therapy for tennis elbow. Pain 1983;16:285-288

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