Dr. Zatrok's blog
Dr. Zatrok's blog

Dr. Zatrok's blog

Dr. Zatrok's blog

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Dr. Zsolt Zatrok – All rights reserved.

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Tendinitis or Tennis elbow
SymptomsTreatments

Tendinitis or Tennis elbow: Symptoms, Causes and Treatment

by Dr. Zsolt Zatrok

Tendinitis or tennis elbow is formed by overuse. It’s not only athletes who struggle with it. It can also affect people who have never held a tennis racket. Unfortunately, the discomfort is not easy to get rid of.

The main cause of tendinitis

When you do repetitive, strenuous physical work with your arm, you overload the points where the tendons of the forearm muscles attach to the bone. A variety of problems can occur. Small tears can develop in the tendon. Parts of the tendon may tear out of the bone or damage the periosteum. Inflammation may develop in these areas. This is the development of tennis elbow – named after its common occurrence among tennis players, but it is not just a condition that affects athletes.

tennis elbow formation site as depicted by the Mayo foundation

It can happen to anyone who makes frequent repetitive movements with their arm. Most often, for example, among carpenters, joiners, carpenters, carpenters, and butchers. It can also be triggered by things that seem “innocent”, such as prolonged mouse use.

It is often caused by the sudden strain (digging, raking, pruning) of spring gardening after a long winter’s “rest”.

I have met patients who have acquired it while caring for a relative who is permanently bedridden. Pulling a heavy body into a sitting position, turning it over when washing, etc. puts a lot of strain on the forearm muscles and through them the points of attachment to the bone.

Symptoms of tendinitis

The pain develops in the arm you use, the one you put the most pressure on

  • Even grasping, lifting or holding a small, light object, or even gripping your hand, can cause very severe pain
  • the pain on the outside of the elbow increases with strain
  • tension of the back of the hand and fingers increases the pain
  • pain may also be excruciating at rest

Home treatment options for tendinitis

One of the most important steps in treating it is to relieve the strain. If possible, you should stop the activity (be it sport or even work) that is causing the discomfort

A wide range of painkillers, steroid and non-steroidal medicines, creams and patches are available. You should be aware that painkillers (usually) have no curative effect, they only suppress symptoms, so it’s worth looking for a solution that also acts on and heals the inflammation.

For recent onset pain, start with cooling. Cooling machine straps that take the shape of the joint are best. If using ordinary ice, also place a towel between the ice and skin. Placing ice directly on the skin and leaving it there for half an hour can lead to frostbite! The analgesic effect of cooling is strongest if the skin temperature is reduced by at least 15°C within 10-15 minutes.

If the cooling doesn’t stop your tennis elbow pain, you can choose to have further physiotherapy treatments. The effects of these are slow to develop – you can expect the pain to ease after 7-10 days of treatment. However, tennis elbow is a very stubborn ‘thing’ and you can expect it to go away completely after 23 months of persistent treatment. In fact… sometimes more than that. In other words, 10-15 days of treatment does not make it go away, it does not mean that the treatment is ineffective, but that the inflammation is extremely persistent.

TENS treatment

TENS devices use electrical pulses to relieve pain. Stick 1-1 electrode 3 to 5 cm above and below the pain and treat in this way. If your device has a modular TENS program, use it, if not, you can choose between the traditional or endorphin programs. TENS is a symptomatic treatment, i.e. although it relieves pain, it has no effect on recovery.

Microcurrent therapy

Microcurrent treatment is similar to TENS, with the difference that microcurrent regenerates the membrane of diseased, inflamed cells and heals effectively, in addition to relieving pain. Thankfully, there are a few devices available that provide microcurrent therapy.

[message title=”Globus Triathlon Pro – With both Microcurrent and TENS therapy” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

    • 23 microcurrent programsGlobus Triathlon pro - with microcurrent and TENS treatment programs
    • Pain reduction, anti-inflammatory treatment and healing stimulant
    • Extensive fitness and sports programs
    • Recovery, warm-up, endurance and strength programs

[/message]

Ultrasound treatment

Ultrasound rays raise the temperature of the treated tissue, accelerating blood circulation and thus the healing process. Always use contact gel for ultrasound treatment. Move the treatment head in a slow, circular motion over the painful area.

Soft laser treatment

Point the laser beam at the most painful point on the tennis elbow and hold it there until 5 Joules of energy are applied to the painful area. Different laser power levels require different treatment times – read the device’s guide! The energy of the laser beam penetrates deep into the tissue, stimulating the healing process. Effectively reduces pain and inflammation.

Examples of soft lasers for tennis elbow and tendinitis treatment at home:

[message title=”Personal Laser L400 Soft Laser” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

    • Laser Power Class 3Soft Laser Personal Laser L400
    • 808 nanometer laser beam
    • 400mW power
    • 12.5 seconds / 5 Joule

[/message]

[message title=”B-Cure Classic Soft Laser” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

    • Laser Power Class1Class 1 Soft Laser, B Cure Classic
    • 808 nanometer laser beam
    • PW (pulsed) laser
    • 250mW power
    • 6 minutes / 5 Joule

[/message]

Magnetic therapy

Pulsating magnetic field therapy using electric current is effective for any joint or tendon condition, including tennis elbow.
Warning: so-called static magnets – not produced by electricity – such as bracelets, necklaces, straps, belts, etc. have no medically proven effect.

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Multimodale Behandlung - was bedeutet das?
FAQMileStoneTreatments

Multimodality treatment – what does it mean?

by Dr. Zsolt Zatrok

To treat a single complaint, a doctor may usually recommend several different treatments. This may involve different modalities. For example, medication, physiotherapy treatments, possibly surgery, as well as dietary advice and exercise guidance. Each of these will have a different effect on your body and your recovery. Some are stronger, some are milder. Used together, they work better than just one of them. Multimodality treatment is given to you to ensure that the different methods work together to complement each other and produce better results.

No “gotcha”

You probably already know that as many people as there are different cases. Even between identical twins there are differences. In addition, everyone lives differently, eats differently, moves differently, etc.
Because everyone is different, there is no single “magic bullet” for treating illness. There is currently no single medical method that works in the same way for all patients and leads to a complete cure.

All patients have different needs and different symptoms.

This is why everyone needs personalised treatment. It is impossible to predict which treatment will be best for a particular individual. For example, two patients with the same complaint may respond differently to the same drug or treatment. One may get relief after the first one, while the other may get worse.

Multimodality treatment – more effective together

Today, the treatment of certain diseases is mostly multimodal. The doctor does not recommend just one method, but several at the same time. Well “mixed” treatments reinforce each other’s beneficial effects and speed up recovery.

A simple example. If you want to make a birdhouse but you only have a hammer, it will never be finished. You need a saw to cut the boards to size. You need a drill to make a hole. A hammer and nails to fasten the boards together. A hook to hang it on a branch. With these you can assemble the birdhouse. However….. you have all the tools, but you use them incorrectly – the hammer to cut, the saw to drill – the result will not be good.
The emphasis is on using the right tools in the right way and in the right order! That’s the only way to get it done.

Sickness management is the same. The point of treatment is to “mix the right tools” and methods in the light of the complaints, symptoms, co-morbidities and test results.

With no way of predicting how the patient will react, there is the potential for error! They may not find the most optimal combination for you the first time. Once a treatment has started, monitoring is very important. On the basis of experience, the doctor may suggest changing some methods or changing the dosage.

This way, the most optimal treatment “package” can be found in a few “steps”

For each condition, there may be differences in what to use first and which can be used together.

Thousands of possible combinations

Guiding treatment is a medical responsibility, but you have a role to play too. It’s not enough to just sit in your armchair and take your pills. Only you can implement the diet and exercise recommendations. If you rely only on pills or surgery and “do not do your bit”, you are less likely to succeed.

The success of multimodality treatment depends heavily on whether you do the parts that apply to you. For your own good…

Example of multimodality management

If you spend all day hunched over in front of monitor, by the end of the day your neck and back will start to burn and ache.

If you take a painkiller pill, it may have a momentary effect, but it will hurt again tomorrow. After all, symptomatic treatment does not eliminate the cause of the pain.

Your complaints are caused by poor posture throughout the day, because your back isn’t properly supported by the chair, and the monitor is in too low a position – so you sit in a hunched position for prolonged periods. Your neck, shoulders and upper back muscles are therefore constantly strained, while your pectoral muscles stiffen. This makes your neck arch forward, your back hunch and your shoulders slump. You feel a tensing pain in your muscles.

But you can be sure that painkillers won’t do much for you. The multimodality approach suggests that you need to do several things to get your symptoms to go away completely.

  1. Replace your chair with one that supports your back.
  2. Lift the monitor up – the centre of the monitor should be at eye level
  3. Take a break for a few minutes every hour and move your pecs and back muscles through some exercises
  4. Occasional massage will speed up the resolution of complaints
  5. Use therapeutic ultrasound to relax stiff muscles
  6. Use muscle stimulation to speed up muscle recovery
  7. Exercise daily to strengthen your neck, back and pectoral muscles

If you don’t do it, your complaints will be constant and plague you every day. If you apply them all at once, the beneficial effects add up and together they produce a rapid – and lasting – improvement.

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