Last year I had the opportunity to attend a conference here in Washington, D.C., that focused on upper extremity injuries. I attended a specific lecture on the nasty, nagging, and otherwise problematic diagnosis of “tennis elbow.”
It does appear that the medical community is making some discernible changes in terms of how this diagnosis is treated. Here is a quick update that may prove useful in terms of dealing with management.
1. Recent studies are pointing to the notion that cortisone injections are largely ineffective at getting rid of this problem. Longitudinal data in some studies suggest that re-occurrence of irritation is not affected by a cortisone injection. This may be due to the notion that extensor tendons – at the attachment sites on the elbow – are not covered by a synovial membrane. (Cortisone has been shown to be more effective in calming inflammation where synovial membranes are present.)
2. In most cases, tennis elbow will resolve by itself within one year. Some data points to as figures as high as 80-85% of cases healing spontaneously. We physical therapists tend to see the 10-15% of problematic cases.
3. Tennis elbow is a degenerative process when it is present for long periods of time. The tendons start to fray and degrade, and in some cases they will detach from the bone entirely.
In terms of conservative treatment (immobilization, exercise, etc.), take a look at our previous blog for ideas and strategies!