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Relieve Tennis Elbow with TCM

What is a TENNIS ELBOW? 

         

          Tennis elbow, also known as lateral epicondylitis, is a painful condition that occurs when the tendons in your elbow are overloaded and swelling, usually by repetitive motions of the wrist and arm (Mayo Clinic, 2021). It is most commonly seen in athletes and people whose jobs involve repetitive use of their hands and wrists, such as plumbers, painters, carpenters, and butchers. The pain of tennis elbow is located on the outside of the elbow, where the tendons of the forearm muscles attach to the bony prominence. It can also spread to the forearm and wrist.

What are the symptoms of TENNIS ELBOW

          The symptoms of tennis elbow (lateral epicondylitis) typically start as pain or an ache along the outside of the forearm and elbow. The pain develops gradually and may worsen over time and spread to the wrist if one continues the repetitive movements in the arm, even when the arm is resting. The pain can persist even if one places his/her arm and hand palm-down on the table and tries to raise the hand against resistance (John Hopkins Medicine, n.d.). The elbow can feel stiff or swollen. Lifting or grabbing small objects, turning a key, or shaking hands can also be weak or difficult.

How does TENNIS ELBOW happen? 

          The tendons in your elbow attach the forearm muscles to the bone. When these tendons are overloaded, they can become inflamed and damaged. This can cause pain, weakness, and stiffness in the elbow and forearm. In some cases, tennis elbow can be caused by a sudden injury, such as a fall or a blow to the elbow. However, it is most often caused by repetitive use of the wrist and arm, such as (John Hopkins Medicine, n.d.):

  • Playing tennis, especially with improper backhand strokes or hitting the ball off center from the racket

  • Using hand tools, such as hammers and screwdrivers

  • Painting with a brush or roller

  • Carpentry

  • Plumbing

  • Bricklaying

  • Gardening

  • Sewing

  • Typing

What are the causes of TENNIS ELBOW in Oriental Medicine? 

 

          The large intestine meridian is one of the 12 major meridians in traditional Chinese medicine. It runs along the outside of the arm, from the index finger to the elbow. The meridian is associated with the muscles and tendons of the forearm, and it is responsible for the health of these tissues. In Oriental Medicine, tennis elbow is believed to be caused by repetitive injury of the tendons with blood stagnation and excess mucus in the corresponding large intestine meridian (Medical Acupuncture, 2010). When the large intestine meridian is blocked or stagnant, it can lead to pain and inflammation in the forearm and elbow, which can cause tennis elbow or other conditions, such as carpal tunnel syndrome. It results in tendinosis, the degeneration of the tendon’s collagen from too much strain and overuse (Cleveland Clinic, 2022).

What can Oriental medicine do to treat TENNIS ELBOW? 

          There are many ways to treat tennis elbow in Oriental Medicine, including acupuncture, acupressure, traditional Chinese herbal medicine, and dietary changes. 

          Acupuncture is a traditional Chinese medicine technique that involves inserting thin needles into specific points on the body. These points are believed to be connected to the body's energy pathways, or meridians. When the needles are inserted, they stimulate the release of endorphins, natural pain relievers. Acupuncture is a safe and effective treatment for tennis elbow, a painful condition that occurs when the tendons in your elbow are overloaded. Acupuncture can help reduce inflammation, improve blood circulation to the injured area in the outer elbow or forearm, relieve pain, and improve function. A study found that acupuncture has fewer adverse events like fatigue, sleep disturbance, and gastrointestinal intolerance than nonsteroidal anti-inflammatory drugs (NSAIDs) for relieving pain in tennis elbow patients (Zhou et al., 2020). Another study also found that acupuncture was more effective than sham acupuncture, which is a placebo treatment that does not involve the insertion of needles, in relieving pain after one treatment and improving functional impairment at the 2-week follow-up (Gadau et al., 2014).

          Ear acupuncture is a safe, inexpensive, and effective treatment for recovery and chronic pain relief (Angelo, 2021). It is a type of acupuncture that involves pressing flower seeds or pellet needles against specific ear points. These points connect to the body's energy pathways or meridians. When the ear points are pressed, they stimulate the release of endorphins - the natural pain relievers. Ear acupuncture can also help to improve circulation and reduce inflammation.

         Traditional Chinese herbs can treat tennis elbow caused by blood stagnation or excess mucus in the form of granules, teas, liquid extracts, powders, capsules, or a custom formula created by an herbalist just for you (Fenneld, 2021). The herbal formula is created by the energy vibration that “correctly stimulates or adjusts the body’s own vibration” (Encyclopædia Britannica, n.d.), which means they work by stimulating the body's natural healing abilities. They can help to reduce inflammation, pain, and muscle weakness. Some of the most common herbs used for tennis elbow include:

  • Turmeric: Turmeric is a powerful anti-inflammatory herb that can help to reduce pain and swelling.

  • Ginger: Ginger is also an anti-inflammatory herb that can help to reduce pain and improve circulation.

  • Bromelain: Bromelain is an enzyme found in pineapple that can help to reduce inflammation, swelling, muscle soreness, and pain (NIH, 2020). 

  • Fenugreek: Fenugreek is a herb that contains anti-inflammatory and analgesic properties. It can be applied as a paste to the affected area to reduce inflammation and pain (Huizen, 2019). 

          Moxibustion is a traditional Chinese medicine (TCM) technique that involves burning mugwort, a traditional Chinese herb, either directly or indirectly over specific acupoints on the body. Moxibustion, used to stimulate the acupuncture points in the body, can also be used concurrently with acupuncture. When combining acupuncture and moxibustion treatment, a moxa block is placed on the handle of the acupuncture needle (Kaputk, 2022). Moxibustion is an effective TCM modality for a variety of conditions, including tennis elbow, because it can help improve blood and fluid circulation and reduce inflammation. It can also help to relieve pain and allow the individual to regain the full range of movement with the occasional recurrence of symptoms (Gadau et al., 2014). 

 

          There are a number of lifestyle recommendations that can help to treat tennis elbow at home, including:

  • Resting the affected arm. This means avoiding activities that aggravate the pain, such as playing tennis or using a hammer.

  • Applying ice or a cold pack. This can help to reduce swelling of the tendons in the forearm and pain. Apply ice for 15-20 minutes at a time, several times a day (Mayo Clinic, 2021). 

  • Taking over-the-counter pain relievers. These can help to relieve pain and inflammation. Acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve) are all effective options if taken for a short period.

  • Doing easy exercises to strengthen the forearm muscles. These exercises can help to prevent the condition from recurring, including:

    • Finger stretches with a rubber band

    • Gripping a soft object continuously, such as a rubber ball

    • Curling the wrists/elbows palm up and palm down

          Rapha Acupuncture is a traditional Chinese medicine (TCM)/Oriental medicine (OM) clinic in Newport Beach, California. We specialize in men's and women's health. We customize treatment plans to each individual patient's needs. Your symptoms, your medical history, and your lifestyle will be taken into account. We also work with you to develop lifestyle changes that can help to prevent tennis elbow from recurring.
If you are suffering from tennis elbow,
call us today! We can help you find relief from your pain and improve your quality of life! 

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References

Angelo, S. S. (2021, April 29). Acupressure and the ear: A healing path. Johns Hopkins Nursing Magazine. Retrieved February 14, 2023, from https://magazine.nursing.jhu.edu/2020/04/healing-path/

Cleveland Clinic. (n.d.). Tendinopathy. Retrieved February 14, 2023, from https://my.clevelandclinic.org/health/diseases/22289-tendinopathy 

 

Deng, H., & Shen, X. (2013). The mechanism of moxibustion: Ancient theory and modern research. Evidence-based Complementary and Alternative Medicine: eCAM, 2013, 379291. https://doi.org/10.1155/2013/379291

 

Encyclopædia Britannica, Inc. (n.d.). Fu xi and the Bagua. Encyclopædia Britannica. Retrieved February 14, 2023, from https://www.britannica.com/science/traditional-Chinese-medicine/Fu-Xi-and-the-bagua 

  

Fenneld. (2021, February 18). What you should know about Chinese herbs. Cleveland Clinic. Retrieved February 14, 2023, from https://health.clevelandclinic.org/what-you-should-know-about-chinese-herbs/

 

Gadau, M., Yeung, W. F., Liu, H., Zaslawski, C., Tan, Y. S., Wang, F. C., Bangrazi, S., Chung, K. F., Bian, Z. X., & Zhang, S. P. (2014). Acupuncture and moxibustion for lateral elbow pain: A systematic review of randomized controlled trials. BMC Complementary and Alternative Medicine, 14, 136. https://doi.org/10.1186/1472-6882-14-136 

 

Huizen, J. (2019, January 31). Is fenugreek good for you? Medical News Today. Retrieved February 26, 2023, from https://www.medicalnewstoday.com/articles/324334

 

Leung, L., & Dorsher, D. T. (2010). How do you treat tennis elbow in your practice? Medical Acupuncture, 22(2), 73–80. https://doi.org/10.1089/acu.2010.2013 

 

Johns Hopkins Medicine. (n.d.). Lateral epicondylitis (Tennis elbow). https://www.hopkinsmedicine.org/health/conditions-and-diseases/lateral-epicondylitis-tennis-elbow 

 

Kaputk. (2022, February 9). Moxibustion: What is it and does it work? Cleveland Clinic. Retrieved February 14, 2023, from https://health.clevelandclinic.org/moxibustion/ 

Mayo Foundation for Medical Education and Research. Tennis elbow. (2021, February 25). Mayo Clinic. 

https://www.mayoclinic.org/diseases-conditions/tennis-elbow/symptoms-causes/syc-20351987 

National Center for Complementary and Integrative Health. (May 2020). Bromelain. Retrieved February 26, 2023, from https://www.nccih.nih.gov/health/bromelain#:~:text=Bromelain%20is%20promoted%20as%20a,bromelain%20is%20promoted%20for%20burns.

 

Yale School of Medicine. (n.d.). Ear acupuncture: A tool for recovery. Retrieved February 14, 2023, from https://medicine.yale.edu/psychiatry/newsandevents/cmhcacupuncture/ 


Zhou, Y., Guo, Y., Zhou, R., Wu, P., Liang, F., & Yang, Z. (2020). Effectiveness of acupuncture for lateral epicondylitis: A systematic review and meta-analysis of randomized controlled trials. Pain Research & Management, 2020, 8506591. https://doi.org/10.1155/2020/8506591

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