Sunday, December 30, 2007
Lateral epicondylalgia
Recent literature (search "google scholar" for examples) indicates that the term epicondylitis is no longer accurate. Apparently, the affected tissues do not correlate with an inflammatory process. Instead, the term epicondylalgia is proposed. This term describes the painful aspects of condition but does not insinuate inflammation as a component. Also, affected tissues are described as containing increased lactic acid and poor oxygen content. This may explain why healing is delayed and symptoms persist for so many people. I believe it also explains why many treatments aimed at decreasing inflammation have variable outcomes. The real crux of the problem is the cause. If the tissues themselves are not responsible, then gua sha is no better than cortisone, counter force braces, or rubbing the elbow with a cabbage. Any thoughts on causes or treatments with long term effectiveness?
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Matt,
I examine to find out how local or secondary the elbow pain is. I check to see if passive or resisted muscle contraction is painful, whether trigger points exist to cause the pain, if any other area like hand/wrist, shoulder, neck or upper back joint/muscle/nerve effects are beating up on the elbow, and if overall posture is contributing.
If the elbow gets chronic and "congested", even if not primary, gua sha can allow for the clean up and rejuvenation when another area of tissue is primary.
But until the primary is being resolved, the elbow will not resolve.
Somtimes gentle medial to lateral ulna mobilization with the humerus counter-held will release the sensitive epicondyle. The radius also needs full rotational and gliding ability and can be tested and gently corrected.
Usually after manual care has begun the improvement, I can add home care to support progress and prevent recurrence.
John...Dr D
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