Tennis Elbow (Lateral Epicondylitis)
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Tennis elbow can develop even if you don't play tennis
Lateral epicondylitis is a condition that causes pain at the bony prominence on the outer side of the elbow. It is commonly called tennis elbow, but in reality it occurs far more often from repetitive everyday activities than from tennis itself. Pain typically arises as degenerative tendinopathy progresses at the point where the Extensor Carpi Radialis Brevis (ECRB) tendon attaches to the lateral epicondyle of the elbow.
The core cause: repetitive micro-injury and incomplete recovery
Repeated motions of bending the wrist back or gripping and twisting objects accumulate micro-tears at the ECRB attachment. Without enough recovery, normal collagen regeneration cannot take place, and the tissue gradually changes into degenerative tissue with abnormal blood-vessel and nerve growth. This is why the condition is classified as a tendinopathy rather than simple inflammation.
- Common age: 35–55 years old, more common in the dominant hand.
- Aggravating motions: turning a doorknob, opening a bottle cap, wringing out a dishcloth, etc.
- Diagnosis: reproducible pain at the lateral epicondyle on Cozen's test and Mill's test.
Korean medicine treatment strategy
In Korean medicine, the core pathology is impaired qi-and-blood circulation at the tendon attachment along with blood stasis (eohyeol, 瘀血). Acupuncture promotes local blood flow and modulates pain signals, while pharmacopuncture (extracts of anti-inflammatory herbs) is injected directly into the tendon attachment to help restore the degenerated tissue. Bee venom therapy in particular is effective for tendinopathy because its melittin component has anti-inflammatory action.
- Acupuncture: stimulating points such as Quchi (LI11), Shousanli (LI10) and ashi points to relieve pain
- Pharmacopuncture and bee venom: direct action on degenerated tissue at the tendon attachment to promote tissue regeneration
- Stretching: wrist-flexion and forearm-pronation stretches to relax the ECRB
- Bracing: a forearm counterforce band to redistribute load away from the tendon attachment
Self-care and prevention
While pain is present, minimize aggravating motions; lifting objects with the palm facing up reduces stress on the lateral epicondyle. Forearm strengthening exercises should begin gradually only after the pain has decreased by more than 70%. With combined treatment and lifestyle correction, most cases can recover without surgery.