Lateral Epicondylitis or Neural?
Lateral epincondylitis / tennis elbow can be a frustrating condition to treat especially if it is misdiagnosed.
Another possible source of pain at the common extensor origin is from the entrapment of the deep branch of the radial nerve as it pierces through the supinator muscle.
It is however often challenging to differentiate between myofascial versus neural elbow pain. One easy way to differentiate is by performing the neurodynamic testing (NDT) Radial nerve bias.
If the NDT radian nerve is positive then there are some things to consider when treating the ?lateral epincondylitis?:
- 1) Do not give them self stretching of the extensor muscles as repeated stretching of a sensitized nerve may in fact irritate the condition
- 2) Do not recommend a tennis elbow brace as the sustained compression of the nerve may in fact further irritate the condition and delay healing
- 3) Avoid friction massage as a sensitized nerve may become even more sensitized with friction massages
- 4) Tape the elbow to temporarily unload the neural tissue.Lateral Epicondylitis? Tape it!
This taping is primarily effective after the application of the Mulligan lateral glide mobilizations.
The tape is attached to the medial aspect of the proximal forearm and tensioned in a longitudinal direction across the anterior aspect of the elbow and fixed on the postero-lateral aspect of the distal humerus.
To test if the tape has worked simply ask the patient to make a grip and ask them if there has been any change in the symptoms.
Posted on: January 14, 2004