Tennis elbow, medically named lateral epicondylitis, is an inflammatory condition affecting the outside of the elbow.

This elbow pain is due to tendonitis and periostitis (inflammation of the outer layer of the bone) where the tendon for the common wrist extensor muscles attaches to the humerus. This results in pain with any activity involving the contraction or moderate stretching of the wrist extensor muscles.

These activities would include writing, typing, lifting objects while the palm is turned down, or using a screwdriver. The pain usually has a gradual onset with no visible swelling. Stiffness or pain in the elbow is usually evident after prolonged periods of rest.

One of the tests for tennis elbow is to attempt to hold on to the top of a book with the palm turned downward. If this proves to be painful in the outside of the elbow, you likely 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.

If this muscle group tightens too much, it will lead to a decrease in joint space in the elbow thereby resulting in an increase in pressure and inflammation in the joint. This results in pain in not only the epicondyle, but the radial-humeral joint as well.

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.

Chiropractic techniques that work well with this condition include soft-tissue therapies such as active release technique, Graston, or cross-fiber friction massage. Chiropractic adjusting of the lateral elbow, including the proximal radial-ulnar joint and the radial-humeral joint, appear to be quite beneficial.

With adjusting, the two joint surfaces are spread apart an estimated one to three millimeters momentarily. This leads to an increase in volume and decrease in pressure in the joint. This will assist in the decrease in pain from the pressure built up in the joint from the condition of lateral epicondylitis. Adjusting of the wrist may be of some benefit as well.

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.

The use of a tennis elbow band may also prove effective in decreasing symptoms. This works by forming an artificial origin for the muscle before it crosses the elbow. This allows a decrease in tension of the wrist extensor muscles as they cross the elbow which eases tension on the lateral epicondyle and decreases pressure on the elbow.

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.

Limiting salt intake may be beneficial as well as it will help to reduce water resorption in the body. Supplementing with vitamin B6 has also been found to be helpful in some cases.

Overall, if you suspect you may have this condition, it is best to have it assessed by your chiropractor and/or medical doctor in order to have the proper treatment plan started that will assist in accelerated recovery.