Tennis elbow: how your pharmacy can help

As we are in the thick of Wimbledon, I thought it would be a good time talk about tennis elbow. Did you know that only an average of 5% of tennis players actually suffer from tennis elbow? Read on to discover what tennis elbow is and what treatments are available to help cope with the symptoms.

What is it?

Tennis elbow is inflammation of the lateral muscle around the elbow. It is quite common and can occur due to a minor trauma to the elbow or a continual repetitive use of the elbow, which can lead to inflammation of the surrounding muscle.

Microscopic tearing can occur within the muscle, which can lead to fibrosis of the tissue surrounding the elbow. It is exacerbated through continual, repetitive and resistive movements of the elbow, wrist and forearm, namely by activities which involve repetitive use such as gripping and twisting objects. It usually occurs in both male and female around the age of 40-50 years. The duration is variable and can be from six months to two years.

What are the symptoms?

Pain can be felt around the elbow which radiates across the forearm. It can be exacerbated by continual wrist movements. Tenderness and palpitations can be felt around the elbow.

Treatments from your pharmacy

Anti-inflammatory medication is the most suitable treatment option for tennis elbow, because it will reduce the inflammation felt around the joint and, therefore, reduce your pain. Here are some common over-the-counter treatment options.

Please note in relation to all the medicated treatments I've listed, always consult a qualified healthcare professional, such as a GP, community pharmacist or practice nurse, prior to taking or using the treatments. Do not exceed the maximum dose stated and always follow instructions on the packet provided.

Ibuprofen: Dose - 200 mg to 400 mg up to three times a day. It is advised these are to be taken with food.

Paracetamol(also known as acetaminophen or Tylenol® in the USA): Dose - 500 mg to 1 g up to four times a day.

Paracetamol and codeine (Co-codamol): Contains: 500 mg of paracetamol and 8 mg of codeine. Dose - 1 to 2 tablets up to four times a day.

Topical (skin) treatments: Diclofenac 1.16% Gel (Voltarol Emulgel®). Dose - a small pea-sized amount (approximately: 2-2.5cm diameter) to be rubbed into the area three to four times a day. Hands should be washed after application.

Deep Heat®: Heat is used to relieve of soft tissue pain. Dose - rub a small pea-sized amount on to the area to relive pain.

Other non-pharmacy treatment options

Prescription medication, which is not available over the counter at pharmacies, include Naproxen (dose - 500 mg first and then 250 mg every six to eight hours) and corticosteroid injections, which can be used for short-term relief. Consult your GP or specialist if this is required.

Finally, here are some non-medicated treatment options:

- Change daily activities to reduce the repetitive movements

- Take frequent breaks from repetitive movements to rest the muscle

- Physiotherapy is a good way to help to repair the muscles and not strain them further

- Ice packs if sudden onset of pain occurs.

A variety of treatments are used to alleviate tennis elbow symptoms and the ones I've highlighted are some of the common options used. Combinations of these medications can be used, for example paracetamol and diclofenac gel. However, it is advisable to speak to a healthcare professional before deciding on a particular medication (paracetamol and co-codamol should not be used in combination).

If you would like further information please do not hesitate to contact me or speak to your local pharmacist about any of the information I've provided above.

References:
http://cks.nice.org.uk/tennis-elbow#!evidence
www.micromedexsolutions.com
http://www.medicines.org.uk/emc/


Yasmin Karsan is a UK registered pharmacist who has a pharmacy-related blog, Ask a Pharmacist, and an Ask a Pharmacist YouTube channel. Follow@YasminKarsan on twitter, Ask a Pharmacist on Facebook or Askapharmacist on Instagram.