The muscles of the back of the forearm run from the wrist to the elbow, where they attach to the upper arm bone (the humerus). It is this tendon, and the surrounding outer layer of bone that become inflamed in tennis elbow. Any movement of the muscle, which puts stress on the tendon, will then cause the characteristic pain of tennis elbow.



It is not just tennis backhands that put a stress on the muscles of the forearm and their attached tendon. Activities such as using a screwdriver, typing, or writing can all cause the typical tennis elbow pain.

Since tennis elbow affects the straightening of the wrist, you can test for it by lifting a weight, such as a book, with your palm facing down. Any pain in the outside of the elbow suggests you 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.

The theory is that since the muscles involved with this condition help to move the wrist, it should aid in the speed of recovery if the wrist motion is maintained. If the wrist tightens, the muscles need to work harder to move the wrist. This results in tightness in the wrist extensors which then exacerbates the condition.

Another therapy that can be very helpful is the use of an elbow band. This works by transferring the tendon's tension from its attachment to the bone (where it causes the pain) to the band instead.

Also, though rest would be ideal, there may be times when lifting is needed to be done. In this case, one should only attempt to lift with the palm of the hand turned upward. This uses the wrist flexors 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.