What is a TENNIS ELBOW?
Tennis elbow, also known as lateral epicondylitis, causes swelling of the tendons, usually due to repetitive wrist and arm motions (Mayo Clinic, 2021). Individuals that often develop tennis elbow from joint movements in their duties and tasks are plumbers, painters, carpenters, and butchers (Mayo Clinic, 2021). The pain of this condition is located where the tendons of the forearm muscles attach to the bony part on the outside of the elbow and can spread into the forearm and wrist.
What are the symptoms of TENNIS ELBOW ?
First, one may experience pain or an ache along the outside of the forearm and elbow. Later, the pain can worsen, and if one continues the repetitive movements in the arm, the pain can spread down to the wrist, even while resting (John Hopkins Medicine, n.d.). The pain can persist even if one places his/her arm and hand palm-down on the table and tries to raise the hand against resistance (John Hopkins Medicine, n.d.). It can also be painful to lift or grab small objects like a cup, turn a key, or shake hands.
How does TENNIS ELBOW happen?
A typical example of how tennis elbow can happen is caused by the action of the tennis racket hitting balls in the backhand position. As a result, the forearm muscles, attached to the outside of the elbow, can become sore from excessive strain as the tendons roll over and become damaged from each repetitive backhand stroke (John Hopkins Medicine, n.d.). While tennis elbow can be caused by those that play tennis due to improper backhand strokes, weak shoulder, and wrist muscles, and hitting the ball off center from the racket, it can also be caused by any repetitive motions such as painting with a brush/roller and regular use of hand tools (John Hopkins Medicine, n.d.).
What are the causes of TENNIS ELBOW in Oriental Medicine?
The causes of tennis elbow in Oriental Medicine are “the repetitive injury of the tendons with the blood stagnation and excess mucus in the corresponding large intestine meridian” (Medical Acupuncture, 2010). This results in “tendinosis,” which is the degeneration of the tendon’s collagen from too much strain and overuse (Cleveland Clinic, 2022).
What can Oriental medicine do to treat TENNIS ELBOW?
Acupuncture can help alleviate the short-term pain of the tennis elbow as it reduces inflammation and improves blood flow to the injured area in the outer elbow or forearm. Although nonsteroidal anti-inflammatory drugs (NSAIDs) have long been used for pain alleviation, including oral administration and external application on painful lesions, studies have found that these treatments have led to an increased risk of adverse events like fatigue, sleep disturbance and gastrointestinal intolerance (Zhou, Guo, Wu, Liang & Yang, 2020). Five randomized trials have compared acupuncture with sham acupuncture (skin stimulation with or without acupuncture needles). The results concluded that needle acupuncture would be more effective in relieving pain after one treatment and improving functional impairment at the 2-week follow-up (Gadau, Yeung, Liu, Zaslawski, Tan Wang, Bangrazi, Chung, Bian & Zhang, 2014).
Ear acupuncture can also be used in recovery as patients fall into a meditative state, otherwise called “needle sleep” (Yale School of Medicine, n.d.). The 5 points of the ear are the Autonomic Point, which works to calm the nervous system and help with relaxation; the Shen Men, which reduces anxiety and nervousness; the Kidney point, which reduces aggression and heals internal organs; the Liver point for detoxification; and the Lung point which promotes aeration (Yale School of Medicine, n.d.). Ear acupressure can also be used as a non-opioid pain reliever that’s inexpensive and effective for chronic pain as a small pellet is pressed against the ear (Angelo, 2021).
Traditional Chinese herbs can be used to improve health as they can come in the form of granules, teas, liquid extracts, powders, a classic formula, and even a custom formula that an herbalist can create just for you (Fenneld, 2021). Some herbs have strictly designated roles, as some are active ingredients used to address the primary symptom and others to manage secondary symptoms. The herbal formula is created by the energy vibration that “correctly stimulates or adjusts the body’s own vibration” (Encyclopædia Britannica, n.d.). Traditional Chinese herbs that can help treat tennis elbow caused by blood stagnation or excess mucus include turmeric and ginger. Other herbs, such as bromelain and fenugreek, can also be used to treat tennis elbow. For example, bromelain can help reduce pain and swelling and improve muscle soreness (NIH, 2020). Fenugreek, containing anti-inflammatory properties, can reduce inflammation and muscle pain from its seeds when ground into a paste for application (Huizen, 2019).
Moxibustion used to stimulate the acupuncture points in the body, can also be used concurrently with acupuncture (Kaputk, 2022). It’s the burning of moxa, a traditional Chinese herb, either directly or indirectly over acupoints. In direct moxibustion, the moxa is placed directly on the skin and ignited (Deng & Shen, 2013). During indirect moxibustion, the moxa is kept at a distance from the skin, and some of the insulating materials include air, garlic, ginger, aconite, and salt (Deng & Shen, 2013). When combining acupuncture and moxibustion treatment, a moxa block is placed on the handle of the acupuncture needle. Moxa is an effective TCM modality for tennis elbow to improve blood stagnation and fluid circulation because it can generate heat and allow the individual to regain the full range of movement with the occasional recurrence of symptoms (Gadau, Yeung, Liu, Zaslawski, Tan Wang, Bangrazi, Chung, Bian & Zhang, 2014).
Some lifestyle recommendations to treat tennis elbow include rest and avoiding activities involving forearm or wrist motion. Applying ice or a cold pack for 15 minutes 3-4 times a day can help with the swelling of the tendons in the forearm (Mayo Clinic, 2021). Over-the-counter pain relievers, such as naproxen, aspirin, and acetaminophen, can be taken for a short period due to the risk of side effects. Some easy exercises for patients with tennis elbow are doing finger stretches with a rubber band, gripping a soft object continuously like a rubber ball, and curling the wrists/elbows palm up and palm down.
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