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Expert Advice-Treatment of Tennis Elbow in Traditional Chinese Medicine(TCM):
TENNIS ELBOW
Acupuncture  for Tennis Elbow

     Many of us have experienced a painful elbow from time to time after a golf game, raking the lawn, or a long session on the computer.  Usually it clears up after a few daysí rest.  But for a lot of people, the pain doesnít go away, and they eventually have to go in for treatment.  Elbow pain which is due to inflammation of the tendons that attach the lower arm bones to the upper arm is usually called "tennis elbow."  It can also be called tendonitis of the elbow, or sometimes "golf elbow."
     In this country, doctors recommend an approach that starts with basic care like resting the elbow, avoiding overuse, and wearing a brace.  Next, physical therapy, anti-inflammatory drugs, or pain killers are tried.  Finally, steroid injections (cortisone shots) may be used in an effort to reduce the inflammation.
     In China, acupuncture is the first choice of doctors and their patients in the treatment of tennis elbow.  More radical approaches like surgery or steroid injections are a last resort.  In my practice, I often see people who have already tried everything that Western medicine has to offer, including steroid injections, and who still suffer with debilitating pain.  One of my patients, Mike, is a good example of this.  He had been a tennis coach for fifteen years, and loved his job, but for the last year he had been experiencing severe elbow pain.  He tried three steroid injections with no relief.  Now he was forced to consider the possibility of giving up tennis for good.  Fortunately, acupuncture worked very well for Mike.  We started with two treatments a week, and after five weeks, his pain had decreased significantly.  Normally, I ask patients to rest their elbow during treatment, but Mike had to continue giving tennis lessons and classes during this time.  Even so, he improved to the point where he could continue with the work that he loved.
     The effectiveness of acupuncture in treating tennis elbow was the subject of a study done in Sweden by Dr. Gunilla Brattberg.  She found that patients treated with acupuncture became much better, or even completely free of pain.  None of them got worse or had any side effects from acupuncture treatment.  Dr. Brattberg noted that acupuncture is a more time-consuming treatment modality than steroid injection, but while there may be dramatic improvement using steroids, there can also be a worsening of symptoms with steroids.  Most acupuncture practitioners find that patients who have had steroid injections are slower to respond to acupuncture treatments than patients who have not been injected.
     What kind of treatment can you expect at an acupuncture clinic?  Exact treatment will vary somewhat from person to person, but most people begin with two acupuncture treatments a week for a few weeks, decreasing the frequency of treatment as the condition improves.  The practitioner may also use electrical stimulation, heat lamp, and herbal patches to speed up the healing.  Because tennis elbow is the inflammation of a tendon, it usually takes longer to heal than an inflamed muscle would, but you should notice at least some improvement after four or five treatments.
     One of my patients asked me an interesting question recently.  Samantha is a flight attendant, and has developed severe tennis elbow pain as a result of her job.  She said, "Iím pretty sure my elbow problem is from carrying a coffee pot around half the day and lifting heavy luggage.  But Iíve only been a flight attendant for five years.  Some of my co-workers have been lifting coffee pots and luggage for twenty years, and theyíre fine.  Is there something wrong with me?"
     It does seem like some people are more at risk to develop this problem than others, even if two people are doing the exact same job.  Chinese medicine has a unique explanation for this, based on the idea that most health problems are due to an internal imbalance of a fundamental substance of the body, like Chi, Yin, or Yang.  In Chinese medicine theory, the Liver controls the tendons.  If there is a deficiency of Liver Yin, tendons will not be moistened and nourished enough, and the tendons will dry out and become inflamed.  When an acupuncture practitioner treats you, he or she will treat the underlying imbalance as well as the symptoms of pain that you have.  Like Mike, Samantha responded to acupuncture very well, and has had no recurrent elbow problems since then.