Tennis Elbow

[rana_sh]

hi.. try modalites like short wave, ultra sound, hydrotherapy, cryotherapy, infrared.. all the modality ised to decrease muscle spasm

[alophysio]

Hi Rana Sh,

I am sorry but electrotherapy and modalities etc are just a band-aid - why not fix the problem rather than just the relieve the symptoms temporarily.

We have already discussed that "epicondylitis" is not the proper term because there is no inflammation present - this is proven with microdialysis of the extensor tendons.

If you want a protocol based on research, look in this post - i have posted it up higher.

Your patient's will not think "wow" when you relieve their pain for up to 1 hour. They will think you are wonderful if you actually fix their problem.

I am just studying "patient satisfaction" at the moment and there are 3 factors that are incorporated into the care of a patient:
1. Information - they want to know what is wrong
2. Caring - they want to know you care about what is wrong
3. Effectiveness - they want your treatment to work - you don't need a degree to put on a hot pack or ice or even put on TENS etc. Anyone can look up the book and put a machine on. Medical reps do it all the time. What you have a degree in is "using your brain".

Sorry about sounding like a rant! I just get frustrated when people can't see the big picture...

[asha]

Short Wave Diathermy for Tennis Elbow? !!!!! Its unheard of. Not done.
asha

[Dr Damien]

Hiya, unfortunately tennis elbow when chronic can be such a pain for physios and patients alike. The sad thing is that the modalities that have been mentioned above are designed to address inflammation mainly. Tennis elbow most recently has been identified as a tendinopathy rather than tendinitis which means that the shortwaves, the Ultrasound etc will not have much effect if there isnt any inflammation to battle. Moreover, there can be a strong resistance to treatment if the causative overuse activities are not concentrated on.The choice of friction massage is debatable because when done too deeply, there can be a mimicking of the overuse rub on bone making the condition worse. Other suggestions for treatment is injection therapy and the modification of activities that cause overuse. You can refer the patients who are resistant to treatment to a specialist in injection therapy,however you must monitor that the patient those not receive too many injection treatments due to the risk of steroid related joint anthropathies,infertility and osteoporosis.
My advice is to refocus your attention to the modification of activities because it is not likely the modalities mentioned above will be of much help, having said that not all patients will respond to treatment alike which means some may benefit from these modalities but treatment without investigating the causative activities in my opinion is useless as the condition is degenerative thats why it affects mainly adults in their thirties to fifties because they are quite active and have the natural degenerative processes begun already.

Modify your patients activities...

[maithili85]

hi
i think MWM and pain release phenomenon techniques are really helpfull in chronic tennis elbow patients.In MWM, if u get proper direction of glide,it helps to relieve the pain.Along with this,a proper ergonomic advice and stretching n strengthening exercise program does help to give adequate relief to patients.It's definitely worth a try.