Treatment of tennis elbow: medications, tapes, braces, rehabilitation and other preparations

The main goal of treatment of lateral epicondylitis is to eliminate pain, remove functional limitations of the joint and accelerate the healing process of the resulting inflammation. The exact course of treatment also depends on the stage and progress of the disease.

Treatment is divided into three basic types:

• Non-pharmacological treatment
• Pharmacological treatment
• Surgical treatment

Non-pharmacological (conservative) treatment

In conservative treatment, rehabilitation and physiotherapy treatment is the mainstay. Rehabilitation exercises are aimed at strengthening weakened muscles and, conversely, at relaxing overstretched muscles.

The therapist performs mobilisation and soft techniques in the upper limb area. He releases muscle spasms, painful muscle fibres and stretches shortened muscles. The patient learns compensatory and relaxation exercises as part of home self-therapy.

Self-massage using massage tools (hedgehog, roller, ball, massage gun...) is recommended.

A frequently used method is kinesiotaping - sticking functional therapeutic tapes on the patient's skin. This way, the soft structures of the elbow joint are fixed, stabilised or released.

Special orthoses are also used to keep the extensor muscles of the forearm still while protecting the outer painful tendon of the elbow joint.

Physical therapy in the form of laser, ultrasound, electrotherapy, thermotherapy or shock wave therapy is also used. The type of physical therapy is chosen based on the desired effect and the stage of the disease.

The primary goals are analgesic (pain relieving) and myorelaxant (muscle relaxing) effects.

The laser and biolamp stimulate collagen production and tissue cell regeneration through their biostimulating effect.

The shock wave sends a mechanical wave into the deep soft tissues of the body, which reduces muscle tension, improves blood circulation and promotes lymphatic drainage.

Ultrasound through the applicator head sends a sound wave that promotes local metabolism and reduces muscle tension.

Tennis elbow thermotherapy can be used negative (cold) or positive (warm). In the acute stages of the inflammatory process, heat input is not desirable.

On the other hand, in long-term chronic phases, a positive form of thermotherapy can be used. However, consultation with a doctor and therapist is necessary. Negative thermotherapy is mainly applied in the form of cryotherapy, compresses and hydrotherapy.

Thermotherapy is mainly applied in the form of ultrasound, infrared radiation, electrotherapy and hydrotherapy.

Pharmacological treatment

Treatment with drugs and medications is aimed at eliminating pain and the inflammatory process of the joint. Drugs from the NSAID (non-steroidal antirheumatic drugs) group are used for their anti-inflammatory effect.

NSAIDs can also be applied topically directly to the elbow area. This form of application also has fewer side effects. Topical application is mainly used in the form of gels, patches and sprays that are applied directly to the affected area.

If treatment with non-sterile anti-rheumatic drugs is unsuccessful, injectable corticosteroid treatment is chosen. Dexamethasone, betamethasone or triamcinolone is used in combination with an analgesic.

An injectable spray with corticosteroids is injected inward locally directly into the affected muscle. After application, rest, cold compresses, and exclusion of sports or increased physical activity are recommended.

Nowadays, the injection method is also offered in the sense of injecting the patient's own atuological blood and blood plasma. The latter increases and stimulates the production of collagen and promotes the differentiation of stem cells and osteoblasts in the damaged area.

Surgical treatment

Surgical treatment is chosen when conservative and pharmacological therapies have failed. Surgical intervention is indicated for long-term chronic problems such as persistent pain and limitation of elbow joint function.

Arthroscopy of radial epicondylitis allows doctors to release the damaged painful tendon of the extensor muscle, loosen the joint capsule, remove scar tissue structures and assess the condition and degenerative process of the articular cartilage.

Surgical intervention has a high success rate in eliminating unwanted symptoms. In most cases, hospitalization lasts several days. Postoperative rehabilitation includes scar care, corrective exercises, soft techniques and physical therapy.

Full return to work and physical activity is individual, but usually occurs approximately 4 months after surgery.