"Tennis Elbow" is not necessarily caused by playing tennis
Causes, Symptoms, and Traditional Chinese Medicine Treatment of Lateral Epicondylitis
Persistent pain on the outside of your elbow, weakness when clenching your fist, and difficulty even holding a cup? You might be suffering from tennis elbow (lateral epicondylitis). This condition is not exclusive to athletes; repetitive motions in daily work can also trigger it. Below, we will elaborate on the causes, clinical manifestations, real case studies, and Traditional Chinese Medicine (TCM) treatment plans for tennis elbow.
⚡ Quick understanding: What is tennis elbow?
Tennis elbow (scientific name: lateral epicondylitis) is a common pain condition caused by frequent overuse or improper use of the forearm, damaging the origin of the wrist extensors and resulting in pain in the outer elbow joint. It is common among people who use computers for long periods, work in printing or cleaning, or play racquet sports. Traditional Chinese Medicine can treat it through manual therapy, acupuncture, and Chinese herbal medicine.
I. Causes of Tennis Elbow
Lateral epicondylitis is caused by frequent overuse or improper use of the forearm, leading to damage at the origin of the wrist extensor muscles and pain around the outer elbow joint, commonly known as "tennis elbow."
Many forearm muscles attach to the radial head and lateral epicondyle of the humerus. Excessive use of the forearm muscles can lead to tightness and stiffness, reducing flexibility. When the wrist moves, it pulls and rubs against the outer elbow, causing fascial inflammation. In severe cases, it can lead to periostitis or even a periosteal tear, which can be difficult to heal.
Acute Trauma vs. Chronic Strain
🔸 Acute Trauma
Sudden forceful wrist flexion or traction injures the origin of the wrist extensor muscles.
🔹 Chronic Strain
Frequent or prolonged wrist extension activities cause chronic cumulative damage to the origin of the wrist extensor muscles.
High-Risk Groups
This condition is mostly caused by occupational diseases and is common among people working in the printing, cleaning, and computer industries. Many office workers frequently type on computers, often suspending their elbows instead of resting them on the desk. This can lead to tight forearm muscles and subsequent pain. Playing racquet sports such as table tennis, badminton, and tennis can also lead to this condition.
💡 Key Point: "Tennis elbow" is not necessarily caused by playing tennis. Any activity that requires repetitive use of forearm and wrist strength can trigger this condition.
II. Clinical Manifestations and Symptoms
This condition mostly affects adults, often due to improper force, leading to restricted forearm rotation. The main clinical manifestations include:
✦ Persistent pain on the outer side of the elbow
✦ Pain and weakness when clenching the fist (e.g., holding a cup, wringing a towel, or sweeping)
✦ Restricted forearm rotation
✦ Generally no obvious pain when resting
If you experience any of the above symptoms during daily activities, it is recommended to seek medical attention early to prevent the condition from worsening to a periosteal tear.
III. Sharing Real Case Studies
Case 1: Jewelry Store Owner — An occupational disease from handling gold
When a jewelry store owner came for consultation, she was puzzled: "I don't exercise regularly, I don't use computers for typing, and I rarely write. But why does my elbow hurt? It hurts every time I clench my fist, even holding a piece of paper. Why?"
It turned out that because the owner is in the jewelry business, she frequently handles gold and diamonds. Handling them too much led to an occupational disease, causing chronic strain in her elbow and resulting in "tennis elbow."
Case 2: The wife who constantly massaged the affected area — Improper care delayed recovery
When a wife came for consultation, the periosteum of her lateral epicondyle was already enlarged, swollen, and hard. She said: "I've seen every doctor; I've spent over a hundred thousand dollars, but it never heals. Doctors injected steroids for me, but unfortunately, it recurred a few months later. It has recurred several times in three or four years and still hasn't healed."
It turned out that the patient kept hitting the painful part of her elbow every day, but this only stimulated the periosteum, continuously causing inflammation. Constantly damaging the affected area meant it had no time to rest and repair.
Case 3: A tennis enthusiast — Trouble caused by a new racquet
A patient who loved playing tennis had played for years without any issues. However, after switching to a new racquet, he developed pain because he hadn't adapted to it, overused his forearm, gripped the racquet too tightly, and used "dead force."
Furthermore, his elbow would feel very painful after every match. This was due to overtraining before matches, leading to excessive fatigue and strain in his elbow, which triggered the condition.
IV. Traditional Chinese Medicine Treatment Methods
🤲
Manual Therapy
Loosens fatigued forearm muscles, realigns meridians, restores elasticity, and improves issues of pulling and rubbing on the outer elbow.
📍
Acupuncture Treatment
Acupoints include tender points (Ashi points), Chize (LU5), Yangxi (LI5), Quchi (LI11), and Shousanli (LI10). A multi-needle encircling technique is used to promote periosteal contraction, relieve pain, and reduce swelling.
🌿
Herbal Medicine Treatment
External application of pain-relieving liniment (Die Da Yao Gao) and internal consumption of blood-activating and stasis-removing pain relief pills (Huo Xue Hua Yu Zhi Tong Wan) for both internal and external treatment, fundamentally improving inflammation and promoting healing.
V. Daily Care and Tips
⚠️ Pay attention when applying ointment
Currently, most Western doctors prescribe ointments for patients to apply at home. However, if the application method is improper, it can damage the periosteum and cause inflammation. It is advised to apply ointment gently and avoid vigorous rubbing.
✅ Daily Care Recommendations
🔸 Apply heat to the affected area: This condition is inflammatory; it is advisable to apply heat with a hot towel to the affected area to help dilate blood vessels, promote blood circulation, and reduce inflammation.
🔸 Dietary restrictions: Avoid shrimp, crab, beef, alcohol, and spicy or irritating foods.
🔸 Adequate rest: Temporarily stop activities involving the affected limb to allow the affected area sufficient rest and recovery time.
🔸 Improve posture: When working, your elbows should rest on the table or armrests to provide support for your forearms, effectively relaxing forearm muscles and reducing strain.
🔸 Stretching exercises: Frequently stretch and flex your arms to relax tendons and maintain the elasticity of your forearm muscles.
VI. Frequently Asked Questions (FAQ)
What are the main causes of tennis elbow?
The main cause of tennis elbow (lateral epicondylitis) is frequent overuse or improper use of the forearm, which damages the origin of the wrist extensor muscles, leading to pain in the outer elbow joint. It is common among people who use computers for long periods, work in printing or cleaning, or play racquet sports. Both acute trauma and chronic strain can cause this condition.
Can I get tennis elbow without playing tennis?
Yes. Tennis elbow is not exclusively caused by playing tennis. Any activity that requires repetitive use of forearm and wrist strength, including typing on a computer, cleaning, carrying objects, or working in the jewelry business, can lead to tennis elbow. This condition is often an occupational disease.
What are the typical symptoms of tennis elbow?
Typical symptoms of tennis elbow include pain on the outer side of the elbow, painful weakness when clenching the fist (e.g., when holding a cup, wringing a towel, or sweeping), and restricted forearm rotation. Patients generally experience no significant pain when at rest.
How does Traditional Chinese Medicine treat tennis elbow?
Traditional Chinese Medicine treats tennis elbow primarily using three methods: First, manual therapy to loosen forearm muscles, realign meridians, and restore elasticity; second, acupuncture treatment, using acupoints such as Ashi points, Chize (LU5), Yangxi (LI5), Quchi (LI11), and Shousanli (LI10) with a multi-needle encircling technique to promote periosteal contraction, relieve pain, and reduce swelling; third, Chinese herbal medicine treatment, including external application of pain-relieving liniment (Die Da Yao Gao) and internal consumption of blood-activating and stasis-removing pain relief pills (Huo Xue Hua Yu Zhi Tong Wan).
What should tennis elbow patients pay attention to in their daily lives?
Patients should temporarily cease activities involving the affected limb, get plenty of rest, and apply heat to the affected area with a hot towel to promote blood circulation. When working, elbows should rest on the table or armrests to prevent the forearm from hanging unsupported. Diet-wise, avoid shrimp, crab, beef, alcohol, and spicy foods. When applying ointment, avoid vigorous rubbing to prevent periosteal damage. Absolutely avoid constantly hitting or pressing the painful area.
What happens if tennis elbow is severe?
If tennis elbow is not treated promptly, fascial inflammation can develop into periosteal inflammation. In severe cases, it can even lead to a periosteal tear, which will be difficult to heal. Therefore, it is recommended that patients seek medical attention early in the onset of symptoms and avoid delaying treatment.
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