Acupuncture for Tennis Elbow

How Chinese medicine understands tennis elbow

In Chinese medicine, tennis elbow is a local Bi syndrome: Qi and Blood blocked where the forearm tendons attach to the outer elbow. That spot sits on the Large Intestine channel, which runs from the index finger up the outer forearm to the shoulder. Points along that channel, near the elbow and further down the arm, are the starting point for treatment.

What is keeping the area blocked decides the rest. The common patterns are:

• Qi and Blood stagnation. Sharp, fixed pain that flares with gripping and repeated use, usually after a period of heavy work or a new activity. Treatment moves circulation through the area.
• Wind, Cold and Damp. An aching elbow that is worse in cold weather and in the morning, and better with warmth. Treatment warms the area.
• Qi and Blood deficiency. Pain that lingers for months and is slow to settle, with a weak grip and general tiredness. In Chinese medicine the tendons are not being nourished well enough to repair, so treatment also builds you up.

Pain on the inner side of the elbow is golfer’s elbow, a different tendon on a different channel. If that sounds like you, see pain in the inner elbow.

What treatment involves

Your first visit at the clinic in Keswick starts with questions about your work, sports and tools, which grips hurt, how long it has been going on, and your general health. I look at your tongue and take your pulse. An assessment usually also includes pressing along the outer elbow and forearm to find the most tender spots, and testing which wrist and grip movements bring on the pain.

Acupuncture is usually the main treatment. Needles go into points around the outer elbow and along the forearm, and into points elsewhere on the arm and body chosen for your pattern. I treat the whole body at every treatment, not only the area that hurts. Acupuncture needles are very fine, typically 0.14 to 0.30 mm. The aim is to ease pain and loosen the forearm muscles that pull on the tendon.

Depending on the diagnosis, treatment may also include cupping or tuina massage to release the forearm muscles, moxibustion to add warmth to the elbow for a Cold pattern, or Chinese herbal medicine: a formula written for your pattern.

Tendons are slow to change, and it helps if the strain that caused the problem also eases. Plan on 5–10 treatments to judge progress.

Between visits

• Reduce the load. Grip more lightly, lift with your palm facing up, and break up repetitive tasks with short rests.
• Check your tools. A thicker handle, a lighter tool or a different mouse position can take strain off the tendon.
• Ask about a brace. A forearm strap worn during activity helps some people. Your physiotherapist or doctor can advise.
• Load it gradually. Tendons usually respond to gentle, gradual strengthening. Do the exercises you have been given, and stop short of sharp pain.
• Don’t stop using the arm entirely. Complete rest for weeks tends to weaken the tendon further.

When to see your doctor first

See your doctor before starting treatment, or promptly if you are already coming in, if:

• The pain started after a fall or a blow to the elbow, or the elbow is swollen and you cannot straighten it.
• You have numbness or tingling in your fingers, or weakness in your hand. The problem may be coming from a nerve or from the neck.
• The elbow is red, hot and swollen, or you have a fever.
• The pain keeps getting worse, or is severe at rest and at night.
• You have neck pain along with pain running down the arm.