By Qineng Tan, L.Ac., Ph.D. & Xiaomei Cai, L.Ac., Ph.D.
Pain in outer elbow or burning sensation in forearm? Tennis Elbow, also called lateral epicondylitis, is a pain condition caused by overuse or repetitive movements of the arm and wrist. Acupuncture and TCM can provide help with healing the muscles and tendons of the elbow and providing elbow pain relief of tennis elbow, golfer’s elbow, or tendonitis, so you can get back to your usual activities.
“Tennis elbow” gets its name from the fact that many people get this type of repetitive use injury from playing tennis and other sports that involve holding a racquet. But tennis elbow doesn’t only occur in athletes; it’s also common among people who have to perform repetitive movements that tax the muscles and tendons of the elbow, forearm, wrist, and hand and involve gripping an object, such as: painting, hammering and sawing (construction workers), cutting or chopping (cooks, chefs, butchers), using a wrench (plumbers), or working on an assembly line.
Tennis elbow is a kind of tendonitis, or inflammation of the soft tissues of the forearm. Tendonitis occurs when the soft tissues that attach muscles to bones sustain microtears and become inflamed. The major muscle involved in movements where the wrist and hand are gripping an object while the elbow is extending, or straightening, is the extensor carpi radialis brevis (ECRB) muscle. The ECRB muscle experiences friction as it moves over the bumpy joining of three bones in the elbow joint. Over time, and with overuse, the tendons that attach the ECRB to the bones can become torn and/or inflamed.
Tennis elbow pain is usually centered right in the outer side of the elbow, and just below the joint, but it can also radiate further down the arm and into the wrist. There might be a burning sensation in the muscle on the outer forearm. Pain and weakness in the elbow and wrist can make it difficult to perform regular actions like holding a cup or using a computer mouse.
Golfer’s elbow is a similar condition in that it is also an overuse injury that causes weakness and pain in the forearm. The difference is that with golfer’s elbow, also known as medial epicondylitis, the inflammation and microtearing occur in the muscles and tendons involved in flexing the arm rather than extending it, or bending the wrist inward towards the palm with a lot of force or speed. These are located on the inner part of the elbow and forearm. This type of repetitive use condition can be the result of swinging a golf club, throwing a baseball, hitting a forceful spin serve in tennis, but also such activities as shovelling, using a heavy tool like an axe or chainsaw, or even just carrying a heavy suitcase with your hand and wrist wrapped around the handle.
Tennis elbow pain can be resolved with rest, but for many people, complete rest is not a feasible or desirable option. Acupuncture treatment has been shown to help provide significant pain relief for tennis elbow. Acupuncture treatment can help to reduce inflammation and improve blood flow to injured areas to aid and speed healing of various types of tendonitis.
Top 5 Symptoms of Tennis Elbow
Signs of tennis elbow usually develop slowly over time and are not caused by any obvious single injury.
- Elbow pain or pain on the outside of the forearm, burning sensation in the outer part of elbow, stiff elbow
- Pain that radiates down to the wrist, wrist pain, stiff wrist
- Stiffness of the elbow, especially first thing in the morning
- Weak grip strength, reduced grip strength
- More severe pain when gripping an object, like a mug or racquet
Symptoms of golfer’s elbow are similar, except that the pain is located on the inner side of the elbow or forearm, as opposed to the outer side. Pain is more likely to radiate to the fourth and fifth fingers (ring finger and pinky finger) than to the wrist. You may feel pain when making a fist.
Wrist pain, tingling in the fingers, and weak grip strength can also be signs of carpal tunnel syndrome.
Medical Treatment for Tennis Elbow
The standard treatment for Tennis Elbow begins with rest, icing, and non-steroidal anti-inflammatory medications (NSAIDs like Ibuprofen or Acetaminophen) to reduce pain and swelling. If the pain persists, or perhaps if a person is not able to avoid the activities that are causing the inflammation, doctors may recommend wearing a brace and may administer steroid injections.
Surgical treatment for tennis elbow is relatively rare and only recommended in cases where rest and pain management medications are not working. An arthroscopic procedure to remove damaged and scarred tissue can help repair the muscles and tendons, but there is usually a long recovery time after the surgery.
A newer form of treatment for chronic tendon pain and inflammation is the F.A.S.T. procedure (Focused Aspiration of Scar Tissue). This is a less invasive procedure that uses ultrasound imaging and ultrasonic technology to remove tiny bits of damaged tissue without any incisions. Recovery time after this procedure is much shorter than with regular tennis elbow surgery.
While pharmacological treatment for pain may help to reduce immediate suffering, medications like NSAIDs and steroid injections come with significant side effects, even if they aren’t immediately apparent. Using these kinds of medications long-term to alleviate chronic pain can take their toll, sometimes causing gastrointestinal distress, weight gain, sleep problems, and other side effects that have a negative impact on overall health. Acupuncture treatment can act as an analgesic to relieve pain without any negative side effects. In fact, the side effects of acupuncture treatment are usually beneficial, including increased circulation, immune function, and stress relief.
Can Acupuncture Treat Tennis Elbow?
The treatment of chronic pain and inflammation with TCM goes back for many centuries. We use acupuncture and other methods to help relieve pain and reduce inflammation related to shoulder pain, knee pain, hip pain, neck pain, sprained ankle, and foot pain. TCM uses a variety of modalities to treat orthopedic pain conditions, including: acupuncture treatment, electro-acupuncture, moxibustion, cupping, Tui Na massage, exercise, and Chinese herbs in formulations for both internal (tea or pills) and external (pain patches) use. This multi-pronged approach can be very effective for reducing pain in the short term, while helping tissues to heal over time.
A controlled study in which patients suffering from lateral epicondylitis were divided into three groups and treated with either massage or acupuncture, or a combination of both, showed that patients who received the combination treatment experienced, for the most part, a complete recovery after twenty sessions.
Another controlled study that compared people suffering from chronic tennis elbow who were treated with real acupuncture versus sham acupuncture showed that at both the two week mark and the two month mark, people who had received acupuncture reported less pain and improved function of the arm joints.
Exercises and Pressure Points for Tennis Elbow Pain Prevention
If you are already experiencing tennis elbow pain or signs of golfer’s elbow, you may need to take some time off from sports or make accommodations to your work in order to rest the muscles and tendons of the forearm. Resting the arm is important for allowing inflammation to go down. Once you’re able to start exercising again, try these home remedies for tennis elbow that will help to prevent tendon problems in the future:
- To prevent repetitive stress conditions like tennis elbow and golfer’s elbow when playing sports, be sure to always warm up before playing and cool down afterwards. Practice your form, with a trainer if warranted, so that you know your technique is good and not contributing to pain or injury. Check your sports equipment regularly to make sure everything is in good condition and the right size and balance for you.
- Pressure points for tennis elbow: If you are experiencing pain in the elbow and forearm, you might try using this acupressure point to help tennis elbow pain: LI11 (Large Intestine Meridian 11) – located right in the crevice of the elbow crease, applying pressure to this point can help move Qi and blood through the joint and bring relief from tennis elbow pain. This point is also helpful for clearing heat and cooling you down after exercise, so it’s a good one to use right after a game or when you finish work.
- Exercises for Tennis Elbow – practicing gentle exercises that strengthen the muscles of the wrist and forearm can help prevent pain and tissue damage. Using light dumbbells or a flex bar can help with grip strength.
Acupuncture Near Me for Tennis Elbow on the Westside of Los Angeles
Whether you are an avid tennis player, or someone who works hard doing physical labor, elbow pain from lateral epicondylitis can really cramp your style. Athletes and active people of all ages need to take care of their bodies appropriately so as to avoid injuries that can lead to chronic pain. Adding acupuncture to your health regimen is a great way of providing basic maintenance for your body. Acupuncture treatment, therapeutic massage, and a good nutrition program can all help you keep your joints moving smoothly, without pain. At Art of Wellness, we have over 30 years of experience in helping to relieve orthopedic and musculoskeletal pain conditions.
*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.