Lateral and Medial Epicondylitis / Tennis Elbow and Golfer’s Elbow

Lateral and medial epicondylitis, commonly known as tennis elbow and golfer's elbow, respectively, are conditions that cause pain and inflammation around the elbow joint due to overuse of the forearm muscles and tendons. Despite their nicknames, these conditions are not limited to athletes and can affect anyone who performs repetitive arm, wrist, or hand motions.

• Lateral Epicondylitis (Tennis Elbow): Pain is centered on the outer (lateral) side of the elbow, caused by overuse of the extensor muscles that straighten the wrist and fingers.
• Medial Epicondylitis (Golfer's Elbow): Pain occurs on the inner (medial) side of the elbow, caused by overuse of the flexor muscles that bend the wrist and fingers.

The cause of both lateral epicondylitis is primarily overuse. Activities involving repetitive wrist or arm movements, such as tennis, golf, painting, typing, or manual labor, can lead to tiny tears in the tendons around the elbow. With overuse, we know that we are more likely to feel tired and have poor posture when executing the same movements. So poor posture or incorrect techniques during physical activities, such as improper gripping or swinging in sports, also increase strain on the tendons and increase the likelihood of injury. Lastly, we should note that tendons naturally lose flexibility and strength with age, making them more prone to injury in people aged 30–50.

The most common symptoms of lateral and medial epicondylitis include the following:

• Pain or burning sensation around the elbow, which may radiate to the forearm or wrist.
• Weak grip strength, making it difficult to hold or lift objects.
• Stiffness and tenderness around the elbow joint.
• Worsening pain during activities like lifting, gripping, twisting, or typing.
• Swelling or mild inflammation in severe cases.

At Korean Acupuncture & Wellness Clinic, treatment of lateral and medial epicondylitis is focused on first and foremost restoring the function of the affected muscles. In cases of overuse, the microscopic fibers that compose a muscle are contracted and lose their flexibility. This leads to stiffness and pain when a patient tries to use that muscle during movement. Acupuncture treatment according to the IMEAST (Intramuscular Electroacupuncture Stimulation Treatment) targets the specific muscles, tendons, and ligaments that are injured to reduce pain, alleviate inflammation, and promote blood flow to damaged tendons, accelerating the healing process.

Treatment Case: 42 year old female

   The patient is a WFH office worker and avid racquetball and badminton player. She complains of pain and tenderness in the inner side of the right elbow, exacerbated by repetitive movements (e.g., typing, lifting, and playing any sports). She had been diagnosed with medial epicondylitis by a physiotherapist approximately 3 months ago. She initially presented with dull, aching pain located on the medial (inner) side of the right elbow, with occasional sharp pains during specific movements. She particularly noted that forward swings while playing sports as well as overhead shots gave her the most discomfort.
   
   Upon examination, there was sensitivity over the medial epicondyle and along the flexor tendons of the forearm. There was also mild stiffness and weakness in the forearm, particularly after activity. The patient expressed distress because she now had difficulty gripping objects tightly without pain or discomfort. This not only kept her from playing sports but also made it difficult for her to perform tasks around the house.
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   Acupuncture treatment according to the IMEAST (Intramuscular Electroacupuncture Stimulation Treatment) was done for this patient, focusing on the flexor muscles of the forearm as well as certain other points in the triceps and extensor muscles. 

   After two weeks of biweekly treatment, there was significant reduction in elbow pain, improved range of motion, and decreased tenderness over the medial epicondyle. The patient noted an improved ability to perform daily tasks and she was able to do her stretching routine with little pain, although she could not return to sports. After another month of biweekly and weekly treatment, there was restoration of functional strength in the forearm muscles, and the patient returned to full activity without significant discomfort. However, the patient was advised to incorporate a better warm-up routine before beginning intense sports activities and possibly undergo personal strength training so that her body can better handle the impact of regular high-intensity activity.