Counterforce brace for elbow

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

The elbow is a hinge joint connecting the upper arm to the forearm.

It consists of the upper arm (humerus) and the forearm bones (the radius and the ulna). Several muscles traverse the elbow joint to allow flexion and extension. In addition, there are multiple ligaments which anchor the joint. As a result, the joint is very stable. The strongest ligament is on the inside of the elbow and is known as the ulnar collateral ligament.

At the distal end of the humerus are the medial and lateral epicondyles. These are important because they serve as the attachment for the common flexor and common extensor tendon groups, respectively.

Lateral epicondylitis is a condition that results from overusing the forearm muscles that extend the wrist. When these muscles are overused, the tendons become inflamed at their attachment to the lateral epicondyle. Small tears in the tendon tissue occur.

While the usual name for lateral epicondylitis is tennis elbow, the condition can be caused by other activities besides playing tennis. Any activity that twists and extends the wrist can lead to lateral epicondylitis. Also, a direct blow to the outside of the elbow can lead to the condition.

Symptoms include:

Pain or tenderness on the outer side of the elbow
Pain when the wrist or hand is straightened
Pain worsened by lifting a heavy object
Pain with making a fist, gripping an object, shaking hands or turning door handles

The type of treatment will depend on the severity of the condition, as well as other factors.

The first step treatment of lateral epicondylitis is eliminating the activities that cause or make the symptoms worse.

Anti-inflammatory medication to reduce the inflammation may help.

Cortisone injections directly into the area are also be an option... but probably not the best option since cortisone weakens tendon tissue.

Ice massage is also recommended.

A tennis elbow strap, or counterforce brace, may be worn so that force is applied to the area just below the elbow. This brace distributes pressure throughout the upper arm, rather than just on the tendon insertion.

Physical therapy exercises designed to stretch and strengthen the forearm muscles are also beneficial.

If the condition does not respond to the above treatments, percutaneous needle tenotomy using ultrasound guidance followed by injection of platelet-rich plasma is generally curative. This is considered the treatment of choice. Surgery is rarely necessary.

For more information on tendonitis, visit our sister site: Tendonitis And PRP

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