The pain that is caused by tennis elbow can persist for some time. As tendons are slow to heal, the symptoms can last for a number of weeks, or months, or, in some cases, they can persist for up to a year. However, tennis elbow is a ‘self-limiting’ condition, which means that it will eventually clear up by itself.
Painkillers
If you have tennis elbow, you should rest the affected arm as much as possible and avoid any activities that put more stress on the tendons.
If you have mild pain, taking over-the-counter (OTC) painkillers, such as paracetamol may help to reduce it. Children under 16 years of age should not take aspirin.
As well as tablets, anti-inflammatory painkillers are also available in the form of creams and gels which you can rub into the affected area. Research has suggested that anti-inflammatory creams and gels may be more effective at providing pain relief from tennis elbow compared with tablets but the relief from pain is only very short term.
Some anti-inflammatories are available over-the-counter (OTC) at pharmacists, while others are only available on prescription. Ask your GP, or pharmacist, for advice about which product is most suitable for you to use.
Vibration Therapy
As tennis elbow is now known to be a lack of inflammation of the tendon, rather than inflammation, vibration devices increase the blood flow to the tendon and increase the speed of healing. This is similar to having a tendon operation where the surgeon will induce inflammation by burning small holes into the tendon. The increased blood flow helps to heal the tendon. Vibration devices work in the same way but without the need for surgery.
There is a second benefit from vibration devices. The frequency of vibrations is precisely set to block the pain of the condition by scrambling the pain signals to the brain allowing almost instant pain relief to occur. This is known as the ‘gate theory’.
Vibration therapy is safe and can be used in conjunction with other treatments. One of the first portable devices for home use is Tenease, a treatment worn over the elbow which directs pain relieving vibration direct to the source of the pain.
Cortisone steroid injections
If your tennis elbow symptoms are particularly painful, and the condition is making movement difficult, a steroid injection may be recommended. Cortisone is the steroid that is usually used because it helps to reduce inflammation.
If you have a cortisone injection, cortisone will be injected into the tender spot in your elbow using a fine needle. It will usually be combined with an anaesthetic so that it is not painful. Most people who have a cortisone injection find that their pain improves significantly, or disappears completely, within four weeks of the treatment.
However, for some people who have a cortisone injection, pain relief is only temporary and it returns after a few weeks. In such cases, two, or three, steroid injections may be needed over the course of a number of weeks. The risk of developing side effects after having a cortisone injection is small, but you may experience some increased discomfort at the site of the injection for up to 48 hours.
Before deciding whether or not to have a steroid injection you should carefully consider the possible implications. For example, a large-scale study which compared patients who had a steroid injection with those who did not, found that although 90% were pain free in the short term, only 70% were pain free one year following treatment.
After having a steroid injection (or injections), you should take care to rest your arm and avoid putting too much strain on it too quickly. As with any injury, you should gradually build up to your normal level of activity in order to prevent the problem reoccurring.
Physiotherapy
If your tennis elbow symptoms are particularly severe, or persistent, your GP may refer you to a physiotherapist. A physiotherapist will be able to show you exercises to help stretch and strengthen your forearm muscles. They may also recommend wearing a bandage, or wrist splint, in order to help support your elbow and to encourage the tendons to heal.
Surgery
In rare cases of severe, persistent tennis elbow, surgery may be recommended. The operation involves removing the damaged part of the tendon in order to relieve the symptoms of pain.
