Elbow tendonitis, also known as tendinopathy, is a condition involving the tendons that connect the forearm muscles to the elbow joint, typically resulting from overuse or repetitive strain. This injury is essentially a degeneration or irritation of the tendon structure rather than a simple inflammation. The two most common forms are Lateral Epicondylitis, or Tennis Elbow, which causes pain on the outside of the elbow, and Medial Epicondylitis, or Golfer’s Elbow, which affects the inside of the joint. Both conditions cause pain, tenderness, and often a reduction in grip strength, which can significantly interfere with daily activities. Healing requires a comprehensive approach that moves from immediate symptom management to long-term structural restoration of the tendon.
Immediate Steps for Acute Pain Relief
Managing the initial acute pain involves immediate actions focused on reducing irritation and protecting the injured tendon. The first and most important step is activity modification and rest, which means avoiding any movement that causes a sharp increase in pain. Repetitive actions, forceful gripping, or heavy lifting should be minimized to prevent further micro-trauma to the tendon fibers.
Applying ice, or cryotherapy, to the painful area for about 15 to 20 minutes several times a day can help manage discomfort. The cold works to numb the nerve endings and reduce localized swelling in the surrounding tissue. For short-term pain management, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can be used to decrease pain.
A counterforce brace or strap is worn around the forearm, just below the elbow. This brace applies targeted pressure to the muscle belly, effectively shifting the point of tension away from the damaged tendon attachment on the bone. By lessening the stress on the irritated tendon during gripping or lifting activities, it provides relief. The brace should be positioned about a thumb’s width below the most painful spot and worn snugly during activities that typically cause pain.
Medical Treatments and Specialized Therapies
When self-care measures do not provide sufficient relief, professional medical intervention becomes necessary. Physical therapy (PT) is often prescribed and may begin with passive modalities to control pain and inflammation. Techniques such as therapeutic ultrasound, deep tissue massage, or dry needling may be used by a therapist to prepare the tendon for active recovery. The physical therapist also guides the patient through specific stretching routines to improve flexibility in the forearm flexor and extensor muscles.
Corticosteroid injections were once a common treatment, offering rapid and potent short-term pain relief. However, this relief is often temporary, and symptoms tend to recur after a few weeks. Repeated corticosteroid use is discouraged because the steroid is catabolic, meaning it can potentially cause further breakdown and damage to the already compromised tendon structure.
Advanced treatments like Platelet-Rich Plasma (PRP) injections offer a regenerative approach to healing. PRP involves drawing a small amount of the patient’s blood, concentrating the platelets, and injecting the resulting solution into the damaged tendon. Platelets contain growth factors that stimulate the body’s natural healing cascade, promoting long-term tendon repair. While PRP may take longer to show an effect compared to corticosteroids, it is superior for long-term pain reduction and functional improvement.
Surgery is considered a last resort, typically reserved for chronic cases that have not responded to conservative treatments. This includes a full course of physical therapy and injections over a period of six to twelve months.
Rebuilding Strength and Preventing Recurrence
The long-term success of healing elbow tendonitis relies heavily on restoring the tendon’s structural integrity, which is achieved through specific strengthening exercises. Eccentric exercises are the most important part of this rehabilitation phase, as they specifically promote tendon remodeling and increase the tendon’s capacity to handle load. An eccentric contraction occurs when the muscle lengthens under tension, such as slowly lowering a weight after lifting it.
For Tennis Elbow, an example is slowly lowering the wrist from an extended position while holding a light weight, focusing on a controlled, slow descent lasting about four to six seconds. These exercises should be performed consistently, typically three times a week, allowing 24 to 48 hours for recovery between sessions. Flexibility is also crucial, and gentle, sustained stretching routines for the forearm muscles help maintain the full range of motion and reduce tension on the tendon attachment.
Long-term prevention requires a careful assessment of the activities that likely contributed to the injury. This ergonomic and technique assessment involves analyzing how tools are gripped, how a mouse or keyboard is used, or the technique employed in sports like tennis or golf. Modifying grip size, adjusting workstation posture, or seeking professional coaching can significantly reduce the strain on the vulnerable tendons. A gradual return to full activity is paramount to ensure the newly remodeled tendon tissue is robust enough to prevent a recurrence.