Tennis Elbow--lateral epicondylitis

[Rod Hagen]

Anyone ever successfully rid themselves of lateral epicondylitis ?  I've been doing the exercises and the Graston and it won't. Go. Away.  I'm probably going to take a 5 day course of Mobic, but does anyone have any wisdom to share?   Thanks!

[Guest]

You're optimistic if you think 5 days of Mobic will do much. Treatment involves physical therapy and tennis elbow braces such as Band-It. Stay on Aleve (or Mobic) until symptoms resolve (get your kidneys checked periodically if you're on those for 3 months or more).

 

[Guest]

[+ nycman]

NSAIDs, ice, and a brace are all a good start.

I said it before, but I believe ice is a "miracle drug". 
The problem is icing the area "enough". It’s a pain 
to be constantly getting up to refill the ice bag.

I love my Polar Ice machine. I don’t own stock in the 
company, but the people who run it are super nice 
and very good at helping find the right device for 
your needs. 

If that fails, steroid injections can help. They usually 
work but you can’t keep injecting them over and over. 

In reality, you’ve got to stop completely whatever activity 
is aggravating it. In college, I got it from playing a video
arcade game too much (no joke), and I would keep playing
despite the tremendous pain it caused. The addiction was
real. 

Edited March 10, 2023 by nycman

[Rudynate]

57 minutes ago, nycman said:

NSAIDs, ice, and a brace are all a good start.

I said it before, but I believe ice is a "miracle drug". 
The problem is icing the area "enough". It’s a pain 
to be constantly getting up to refill the ice bag.

I love my Polar Ice machine. I don’t own stock in the 
company, but the people who run it are super nice 
and very good at helping find the right device for 
your needs. 

If that fails, steroid injections can help. They usually 
work but you can’t keep injecting them over and over. 

In reality, you’ve got to stop completely whatever activity 
is aggravating it. In college, I got it from playing a video
arcade game too much (no joke), and I would keep playing
despite the tremendous pain it caused. The addiction was
real. 

I cured a persistent shoulder injury by icing it.  

I used a shoulder wrap that I got here.  It was hard to do, but I completely stopped doing any kind of shoulder exercise.  I iced the shoulder about 3 times in a day, for 30-40 minutes at a time.  It took several months - I would say 4 months.   After that, I had to rehab the shoulder because I had lost so much strength in it.   I have told other people about it, but they can't handle the idea of not using their shoulder and icing it every day for several months, but that's what it takes. 

[Guest]

4 hours ago, nycman said:

...If that fails, steroid injections can help...

Steroid injections for this condition are controversial. They could do more harm than good.

https://jamanetwork.com/journals/jama/fullarticle/1568252

"...Corticosteroid injection resulted in lower complete recovery or much improvement at 1 year vs placebo injection (83% vs 96%, respectively; relative risk [RR], 0.86 [99% CI, 0.75-0.99]; P = .01) and greater 1-year recurrence (54% vs 12%; RR, 0.23 [99% CI, 0.10-0.51]; P < .001)..."

[Guest]

4 hours ago, nycman said:

...In reality, you’ve got to stop completely whatever activity is aggravating it...

Now, that's very good advice.... 😁

Edited March 10, 2023 by Unicorn

[Rod Hagen]

Thanks everyone.

My doctor recommends against steroid injection.

I already had an elbow brace from Air Cast ordered.

I do the exercises from both these sites:

 

I have great success with Mobic, so I started a week's treatment of that.  I never use Mobic for more than a week at a time.

I'm using a Graston as well.  

Wish me luck!

Does anyone else have any advice or experiences to share please?

[Guest]

I think you're being too optimistic if you think one week will be enough. On the bright side, in the study I referenced 96% of those who didn't get an injection were well in one year, but I suspect your recovery will happen over weeks or months, not days. The two main dangers of long-term Mobic use are stomach bleeding and kidney damage. If you get stomach bleeding, just stop and it'll go away. Kidney damage would occur over a period of months. Not a bad idea to check kidney function before going on a long-term course of Mobic, then every 3 months. If you want to be extra cautious, you can do the same with a blood count (CBC) and iron studies to make sure you aren't losing blood. I had plantar fasciitis pain for the better part of a year, and I thought I'd never get better. Not fun for a traveling man such as myself, hobbling around the world. 😢 My beau was kind enough to walk the dog when I couldn't. 

[Rod Hagen]

8 hours ago, Unicorn said:

I think you're being too optimistic if you think one week will be enough. On the bright side, in the study I referenced 96% of those who didn't get an injection were well in one year, but I suspect your recovery will happen over weeks or months, not days. The two main dangers of long-term Mobic use are stomach bleeding and kidney damage. If you get stomach bleeding, just stop and it'll go away. Kidney damage would occur over a period of months. Not a bad idea to check kidney function before going on a long-term course of Mobic, then every 3 months. If you want to be extra cautious, you can do the same with a blood count (CBC) and iron studies to make sure you aren't losing blood. I had plantar fasciitis pain for the better part of a year, and I thought I'd never get better. Not fun for a traveling man such as myself, hobbling around the world. 😢 My beau was kind enough to walk the dog when I couldn't. 

Thank you.  Even with my usual daily PPI (Dexilant) and also preemptive daily H2-Antagonists and eating only mild food, Mobic can (not always) give me terrible Reflux.  So in the rare instances I take it to fight inflammation, specifically swelling, from occasional sport injuries, I do it for no longer than a week at a time and then give myself a buffer before restarting it if needed.   

I hope your Plantar fasciitis recedes soon, or is gone.  For me the real PF fix, in addition to PT-prescribed exercises and stretching, was amazing orthotics.  I saw Dr. Glen Pfeiffer, he's an orthopedic surgeon at Cedars who doesn't like to do surgery, and he took one look at my orthotics, told me my podiatrist doesn't seem to know what he's doing, and sent me to his preferred podiatrist who made PERFECT orthotics for me, and the PF resolved quite speedily.  Good luck!

Edited March 11, 2023 by Rod Hagen

[Rod Hagen]

23 hours ago, Rudynate said:

I used a shoulder wrap that I got here.  

I used one just like that, with great success, after I chipped a bone in my shoulder after a Mountain Bike crash.  Afterward, I was in my car, at the trailhead, bike in the backseat instead of on the roof I could no longer reach, on my phone on Amazon looking for "wearable ice shoulder wrap" so I could order it before departing on my painful 2-hour drive home.  Glad it helped you too.

[Rod Hagen]

On 3/10/2023 at 7:25 AM, nycman said:

In reality, you’ve got to stop completely whatever activity 
is aggravating it. In college, I got it from playing a video
arcade game too much (no joke), and I would keep playing
despite the tremendous pain it caused. The addiction was
real. 

I would if I could figure out what activity is aggravating it.  Normally, I would guess it was giving massages and/or Rock Climbing, but I haven't done either more than once in the last month and a half.  Even though I always stretch and warm up my wrists at the start of a session, it may be Yoga.  I've been doing very active Yoga for years now so that seems odd.  BUT it does hurt when I hold my Down Dogs and Side-Planks, so wether or not that was the cause I guess it doesn't matter, active Yoga aggravates it, so I have to put that on hold for now.  I can still do boring Yin Yoga.  And I can keep swimming.  And, if the rain stops, I can snowboard, so I shouldn't complain.  Thanks!

I get it, I Loved Video games when I was a kid, but I sucked at them.

Edited March 11, 2023 by Rod Hagen

[+ Charlie]

I had my first experience with "tennis elbow" long before I started playing tennis. It began after I carried a very heavy box in front of me on a long walk to the post office. My doctor tried various things without success, so he sent me to an orthopedist who treated piano students at a noted music school. He examined me and said, "You need a cortisone shot," and gave it to me in the elbow. Within an hour the pain was gone, and it didn't return until years later, in a much milder form, when I really was playing a lot of tennis. Another doctor gave me another cortisone shot, but that time it didn't get much better. I wore an elbow brace and changed my service motion, and eventually it faded away.

[Guest]

3 hours ago, Rod Hagen said:

Thank you.  Even with my usual daily PPI (Dexilant) and also preemptive daily H2-Antagonists and eating only mild food, Mobic can (not always) give me terrible Reflux....

Mobic does not and cannot cause reflux. It does impair clotting, which is the reason for the bleeding risk, but it has no effect on the lower esophageal sphincter, which is what it would need to do to worsen reflux. I would be more worried about the long-term use of Dexilant than the long-term use of Mobic. Long-term use may increase your risk of infections including C. difficile colitis and pneumonia, B12, calcium, and magnesium deficiency, and bone fractures/osteoporosis (unlike the long-term effects of Mobic, which can be monitored and prevented). I know it's tough to stop those meds, but I'd look away from Dexilant if possible. Pardon Dinah Shore's grammar. It should be "I wish I were in Dixie." Those southerners...

 

Edited March 11, 2023 by Unicorn

[Rod Hagen]

53 minutes ago, Unicorn said:

Mobic does not and cannot cause reflux. It does impair clotting, which is the reason for the bleeding risk, but it has no effect on the lower esophageal sphincter, which is what it would need to do to worsen reflux. I would be more worried about the long-term use of Dexilant than the long-term use of Mobic. Long-term use may increase your risk of infections including C. difficile colitis and pneumonia, B12, calcium, and magnesium deficiency, and bone fractures/osteoporosis (unlike the long-term effects of Mobic, which can be monitored and prevented). I know it's tough to stop those meds, but I'd look away from Dexilant if possible. Pardon Dinah Shore's grammar. It should be "I wish I were in Dixie." Those southerners...

 

 

NSAIDS can cause stomach irritation, or heartburn.  If it's not TECHNICALLY reflux that's only important technically.  So, ok, I won't call it reflux I'll call it heartburn, which is more accurate.  Thank you.

How about this as a response, "Reflux from Mobic seems unlikely, you probably described heartburn, which NSAIDS can cause.  I presume you are taking it with food as described on the bottle?"  It's still a bit condescending, particularly that last bit  :-) but still descriptive and helpful. 

I am aware of the significant concerns re: long-term PPIs, after all if you read the box, it says to use for only, I think 14 days at maximum.  Also, articles come out OFTEN in the general press about all those PPI complication, and possible complications, which you listed out.  And more!  in fact I was once hospitalized with C-Diff.  YUCK!. 

As of now, it's a quality of life question, because every time I try to rely solely on H2 Antagonists, I have horrible problems eventually no matter how careful I am with what I eat.  In those instances of flare up, there have been times I keep the Liquid Carafate bottle VERY nearby so I do not forget a dose. 

My partner and my two ENTs are in the same boat.  We WANT to get off PPIs, but then our quality of life sucks.  What to do?

Anyway, back to my elbow, while I go see to my poor friend at Cedars.

Edited March 11, 2023 by Rod Hagen

[Guest]

My intention was not to sound condescending, so I'm sorry if you took it that way. My post was intended to be informative. Obviously Mobic can cause stomach upset, which can be confused with reflux. An NSAID designed not to do that is Celebrex. If you truly can't stop Dexilant, I'd get a bone density (DEXA) scan every 5 years or so. 

Edited March 11, 2023 by Unicorn

[jeezifonly]

The brace worked for me when I was on a project that had element(s) of specific time-sensitive repetitive motion. There were a few movements where I felt it but I couldn’t pinpoint the exact problematic combo of reaching, turning, gripping, and holding the object. It was all stuff I’d been doing forever, but positioning/timing was somehow unique to the situation. 

I was lucky - able to find the exact spot I needed pressure, found an Ace brace at CVS, wore it constantly as it really helped, and when the project ended, the pain subsided,  and I continued with the brace for a few week as a precaution. Continued working for another 10yrs with no flare-up.  Lucky. 

[Rod Hagen]

On 3/11/2023 at 12:13 PM, Unicorn said:

My intention was not to sound condescending, so I'm sorry if you took it that way. My post was intended to be informative. Obviously Mobic can cause stomach upset, which can be confused with reflux. An NSAID designed not to do that is Celebrex. If you truly can't stop Dexilant, I'd get a bone density (DEXA) scan every 5 years or so. 

I love condescending.  :-)  Thank you.  I'll stick with the Mobic, so far it hasn't given me a problem this round and I think it's helping.  I do get bone Density scans, thank you, and so far so good.

On 3/11/2023 at 4:30 PM, jeezifonly said:

The brace worked for me when I was on a project that had element(s) of specific time-sensitive repetitive motion. There were a few movements where I felt it but I couldn’t pinpoint the exact problematic combo of reaching, turning, gripping, and holding the object. It was all stuff I’d been doing forever, but positioning/timing was somehow unique to the situation. 

I was lucky - able to find the exact spot I needed pressure, found an Ace brace at CVS, wore it constantly as it really helped, and when the project ended, the pain subsided,  and I continued with the brace for a few week as a precaution. Continued working for another 10yrs with no flare-up.  Lucky. 

Thank you.  I can't tell if it's getting a bit better because of the Mobic, or because I stopped doing the active, forearm engaging, Yoga for now, or both but I'm glad it's receding bit by bit.  Glad yours didn't come back.

[+ Pensant]

Mine has finally resolved. The cortisone shot a year ago also worked. I can do pull-ups, toes to bar, etc. with no discomfort. Even wall balls. My nephew is an ortho and he suggested PRP if it recurs. Now I’m getting over a minor right heel issue. I have some morning foot exercises that help along with applications of Dragon Balm, a TCP-derived product that works wonders. It’s available in WA State.

[Ds35mm]

The problem is usually a weak shoulder girdle. As pain in the elbow subsidies with ice, PT , friction massage, start shoulder strengthening. 

[CalTec]

On 3/11/2023 at 1:13 AM, Rod Hagen said:

Thanks everyone.

My doctor recommends against steroid injection.

I already had an elbow brace from Air Cast ordered.

I do the exercises from both these sites:

 

I have great success with Mobic, so I started a week's treatment of that.  I never use Mobic for more than a week at a time.

I'm using a Graston as well.  

Wish me luck!

Does anyone else have any advice or experiences to share please?

 

Theraband flexbar worked wonders for me, safe to assume you've already been using them?

 

 

[+ FreshFluff]

@Rod Hagen, Have you had any imaging done? It might be worthwhile if PT/home exercises aren't working. Tennis elbow can be a symptom of degenerative disc disease on the c-spine.

 

[Rod Hagen]

On 4/7/2023 at 9:24 PM, FreshFluff said:

@Rod Hagen, Have you had any imaging done? It might be worthwhile if PT/home exercises aren't working. Tennis elbow can be a symptom of degenerative disc disease on the c-spine.

 

Thank you FreshFLuff.  It is a lot better, BUT it's still stubbornly there.  I have appointments with two separate hand/elbow surgeons in the hopes that one of them will inject cortisone (I understand they are controversial, thank you Unicorn).  And if that doesn't take care of it, then yes, definitely imaging.  

[Rod Hagen]

Again, thank you everyone.   Turns out Mobic does not cause me heartburn, either it used to or I had horrible heartburn the last time I used it, but it was unrelated.  In any case, I took Mobic once a day for several weeks, and really leaned into the home Physical Therapy.  I do think that if you do exercises to help alleviate the pain from Tennis or Golfer's elbow, you should do it every other day or every two days, because every days may simply irritate it further.  So, for me, it was fixed with anti-inflammatories and these, fantastic, exercises.

And, as someone here said, the most important thing you can do to get rid of the problem, is to eliminate for as long as you can whatever activity likely caused the injury in the first place (probably not Tennis or Golf).   For me it was Yoga.

 

p.s. I did get a steroid injection, it did seem to help, but I think the NSAIDs and the exercise, AND stopping Yoga for some time, were the true solutions.

 

 

 

Edited July 3, 2023 by Rod Hagen