In what is said to be the largest analysis to date, researchers and clinicians at Beth Israel Deaconess Medical Center compared the safety and effectiveness of non-surgical treatments for Tennis Elbow.
Published in the American Journal of Sports Medicine, the meta-analysis revealed that NONE of the 11 non-surgical treatments examined performed significantly better than placebo in addressing patients’ pain and that all increased patients’ odds of adverse events.
The treatments examined, included the following:
- Physical therapy,
- Anti-inflammatory pills,
- Therapeutic Ultrasound,
- Botulinum toxin injections,
- And Laser therapy
“All 11 treatment options provided only small pain relief, while increasing the odds of adverse events,” said Ara Nazarian, PhD, a principal investigator in the Center for Advanced Orthopaedic Studies at BIDMC and Associate Professor of Orthopaedic Surgery at Harvard Medical School.
“More than 90 percent of the patients given placebo experienced pain resolution after four weeks.”
One of the key conclusions in this study was:
“That implies that, for most patients, tennis elbow is a self-limiting condition,”
A Self-Limiting Condition?
I’ve been seeing this reference on medical sites for a couple of years now, about how Tennis Elbow is supposedly a condition that resolves on its own given enough time.
My impression is that it sounds a bit like a cop out, considering how many people end up suffering for months and even years and end up giving up beloved activities, like tennis and golf, because of it.
(Do they also decide to “just live with it” and drop out of treatment and, hence, fall out of the medical system’s tracking and statistics, the way the unemployed “fall out” of government labor statistics when they give up and stop looking for a job?)
On the question of “How long does it take to heal?” you will get answers from conventional medical websites, like WebMD, that range from a few months to TWO years!
The National Health Services, in the U.K. echos the claim that Tennis Elbow is a “self-limiting condition” seems to contradict itself when it also states that “…it can persist for over a year”
How can an injury that persists for over a year be a self-limiting condition!?
Why Are Most Treatments Ineffective?
To me, it seems obvious that most treatments – especially most conventional medical treatments for Tennis and Golfer’s Elbow – are not effective is because they treat the symptoms and don’t address the underlying problem.
The pathology of the injury is not one of “chronic inflammation” – That’s a very persistent fallacy – but a medical myth nonetheless.
Therefore any treatment directed at alleviating this supposed marker or symptom of Tennis Elbow is bound to fail.
Tennis Elbow is almost always found to be a condition known as Tendinosis
Tendinosis is a degenerative condition marked by the absence of inflammation, healing and regeneration, which makes it a much more challenging injury to treat and recover from than a cut, scrape, contusion or fracture…
OR classic Tendonitis, which does exist and may be the issue is some cases of Tennis or Golfer’s Elbow in the earliest phase of the injury.
But when someone is still suffering six months later – or longer – the likelihood is that the condition has failed to heal and has become degenerative.
MRI’s, which are not often taken in the early stages, rather in the mid-to-latter stages, reveal degenerative changes (and sometimes tears, resulting from the weakening of the tendon due to degeneration) more than any other pathology.
The good news is that tendons can and do heal… Degeneration can be reversed if it hasn’t progressed too far – but its not a simple, easy task!…
And it’s not likely to be a self-limiting condition that resolves by Resting, Hoping and Waiting!