The pain of tennis elbow is caused by inflammation of the tendon and periosteum (the outer layer of the bone) where the tendon from the back of the forearm joins the humerus (upper arm bone). The tendon connects the bone to the muscles that straighten the wrist. Any tension on that muscle - for example from a tennis backhand - will cause pain.



These activities would include writing, typing, lifting objects while the palm is turned down, or using a screwdriver. The pain usually has a gradual onset with no visible swelling. Stiffness or pain in the elbow is usually evident after prolonged periods of rest.

One of the tests for tennis elbow is to attempt to hold on to the top of a book with the palm turned downward. If this proves to be painful in the outside of the elbow, you likely have tennis elbow.

This condition is ultimately due to overuse of the wrist extensor muscles. These muscles attach to the humerus just above the elbow joint on the outside of the elbow. The muscles then continue down the back of the forearm. The tendons then travel across the back of the wrist and hand and connect onto the fingers. These muscles contract to help extend the wrist moving it toward the back of the hand.

Too much tension in the muscle group can also cause a decrease in the joint space in the elbow and actual inflammation of the joint. In time this can cause not just the typical pain from the epicondylitis, but also from the elbow joint itself.

Conventional treatment of this condition may involve the use of anti-inflammatory medication and muscle relaxants along with temporary lifestyle modification. Physiotherapy modalities that may be employed include laser therapy, TENS, interferential current, or ultrasound.

Since the elbow joint can get involved, chiropractic manipulation of the joint, for instance using Graston, active release, cross-fiber massage or other soft-tissue therapies, can be very helpful.

The aim of the chiropractic adjustment is to momentarily separate the joint surfaces in the elbow by just one to three millimeters. This takes the pressure off the joint, and eases the pain. It may be that some manipulation of the wrist can also help.

As we have seen, it is tight muscles that cause the elbow pain. But if the wrist tightens up, the muscles have to work harder, thus putting more tension on that lateral epicondyle. So keeping the wrist supple and flexible should help to ease the condition.

Another technique for relieving the pressure on the point at which the tendon connects to the bone is by wearing an elbow band. This mechanically transfers the tension away from the bone and into the band, which then results in less pain.

Rest would, of course, be ideal. But sometimes some lifting has to be done. In that case , be careful to make sure that you only lift with the palm of the hand turned upward. This causes the wrist flexors to be used more than the wrist extensors.

You can also try supplementing with Vitamin B6 and limiting your salt intake as it helps to reduce the amount of water taken in by the body.

In closing, if you feel that you may have this ailment, the best course of action is to have it looked at by your medical doctor or chiropractor so that the best treatment plans can be started to assist in recovery.