Ask an expert - muscles and bones - arm

17 questions

File under muscle and bone - arm

As you might imagine, we have been asked questions about tennis elbow on a number of occasions and a typical answer has been:

Tennis elbow is one of the more frequent conditions with which people present at our practices.

 The BAcC has a factsheet which outlines some of the research which has been unertaken

 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tennis-elbow.html

 although it would be fair to say that the results are not as clear as for some other conditions for which we prepare factsheets. 

 Our clinical experience is that many people do benefit from having treatment but we are always very careful with conditions like this. If someone has four for five sessions without any apparent benefit we tend to draw a sharp line in the sand and look for alternative options for treatment. If treatment is likely to be successful there is usually some improvement, even if it reverts to being not so good again, and the improvements are incremental, i.e they get a little more pronounced each time. If nothing happens or there is a similar temporary burst of better times each time, then the chances are that acupuncture is not the best option.

 The key thing is to set measurable targets: how far can someone turn the arm without pain or restriction, how much weight can they sensibly bear, and so on. There is often also 'homework' - it is remarkable how many people want to carry on playing golf or windsurfing while they are being treated, and the concept of 'two steps forward, one step back' is difficult to get across sometimes.

 Best advice, as always, is to visit a local BAcC member for an informal assessment of what may be possible. Most BAcC members are happy to spare a few minutes without charge to see what may be possible, and this way you get to meet the practitioner and see where they work before committing to treatment.

This is still the essence of what we would say now. Further evidence keeps on being generated, as for example in this trial published last year

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783565/

but the overall weight of evidence is not enough at present to make firm recommendations.

We are not quite sure what to make of your GP's suggestion. Certainly without sight of your problem we are a little in the dark. If there is strong clinical evidence suggesting that surgery is the best option then it would be wise to follow the advice you are being given. Cutting is usually only done as a last resort, and if that is what the scans and X-rays show then acupuncture may not work. However, it can certainly be said that it won't make things worse, and it might well be worth having three or four sessions to see what can be achieved to head off surgery if this is at all possible.

 

 

Q: i suffer from severe tennis elbow.  I've had 6 steroid injections and that only helps it for a few months a time.  I was just wondering weather acupuncture would have a bit more success?

A:Tennis elbow is one of the more frequent conditions with which people present at our practices.

 The BAcC has a factsheet which outlines some of the research which has been unertaken

 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tennis-elbow.html

 although it would be fair to say that the results are not as clear as for some other conditions for which we prepare factsheets. 

 Our clinical experience is that many people do benefit from having treatment but we are always very careful with conditions like this. If someone has four for five sessions without any apparent benefit we tend to draw a sharp line in the sand and look for alternative options for treatment. If treatment is likely to be successful there is usually some improvement, even if it reverts to being not so good again, and the improvements are incremental, i.e they get a little more pronounced each time. If nothing happens or there is a similar temporary burst of better times each time, then the chances are that acupuncture is not the best option.

 The key thing is to set measurable targets: how far can someone turn the arm without pain or restriction, how much weight can they sensibly bear, and so on. There is often also 'homework' - it is remarkable how many people want to carry on playing golf or windsurfing while they are being treated, and the concept of 'two steps forward, one step back' is difficult to get across sometimes.

 Best advice, as always, is to visit a local BAcC member for an informal assessment of what may be possible. Most BAcC members are happy to spare a few minutes without charge to see what may be possible, and this way you get to meet the practitioner and see where they work before committing to treatment.

Q:  I suffer from severe tennis elbow.  I've had 6 steroid injections and that only helps it for a few months at a  time.   I was just wondering whether I would have more success with acupuncture? 

A:  Tennis elbow is one of the more frequent conditions with which people present at our practices.

The BAcC has a factsheet which outlines some of the research which has been unertaken

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tennis-elbow.html

although it would be fair to say that the results are not as clear as for some other conditions for which we prepare factsheets. 

Our clinical experience is that many people do benefit from having treatment but we are always very careful with conditions like this. If someone has four for five sessions without any apparent benefit we tend to draw a sharp line in the sand and look for alternative options for treatment. If treatment is likely to be successful there is usually some improvement, even if it reverts to being not so good again, and the improvements are incremental, i.e they get a little more pronounced each time. If nothing happens or there is a similar temporary burst of better times each time, then the chances are that acupuncture is not the best option.

The key thing is to set measurable targets: how far can someone turn the arm without pain or restriction, how much weight can they sensibly bear, and so on. There is often also 'homework' - it is remarkable how many people want to carry on playing golf or windsurfing while they are being treated, and the concept of 'two steps forward, one step back' is difficult to get across sometimes.

Best advice, as always, is to visit a local BAcC member for an informal assessment of what may be possible. Most BAcC members are happy to spare a few minutes without charge to see what may be possible, and this way you get to meet the practitioner and see where they work before committing to treatment.



A: As far as the condition itself is concerned, as our factsheet shows:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tennis-elbow.html

there is a small amount of fully researched evidence that acupuncture can provide short-term relief for the problem. The criteria for quotable research set the bar very high by employing research requirements more suitable for drug testing, the randomised double blind control trial. In daily practice tennis elbow is one of the more frequent named conditions for which people seek help from acupuncturists. Our usual recommendation to patients is to have two, three or four sessions along with trying as much as possible not to have to do the sorts of things which brought the condition on. 

We tend to look for regular reviews after four or five sessions and measurable outcomes - range of movement, weight bearing etc - to ensure that a pattern does not develop of ten or more sessions without any result. This tends to make unhappy patients, so we are very clear about drawing a line if there is no discernible change after the first few sessions.

On balance we think that the best advice we can give you is to visit a BAcC member local to you to see what they make of the problem that you have and by virtue of a face to face assessment offer you a very clear idea of what may be possible for you. 

Q:  Can acupuncture help with tennis elbow? I have this problem in both of my arms.  if so, what would the probable cost be, and who would be the best acupuncturist to contact?

As far as the condition itself is concerned, as our factsheet shows:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tennis-elbow.html

there is a small amount of fully researched evidence that acupuncture can provide short-term relief for the problem. The criteria for quotable research set the bar very high by employing research requirements more suitable for drug testing, the randomised double blind control trial, and in practice tennis elbow is one of the more frequent named conditions for which people seek help from acupuncturists of every persuasion, traditional, medical and physiotherapy. Our usual recommendation to patients is to have two, three or four sessions along with trying as much as possible not to have to do the sorts of things which brought the condition on. This is often a sports activity, but we have come across people in kitchens and laundries with issues from repetitive use of the joint.

The fact that you have the condition in both elbows we find a little surprising. Most examples we come across are linked to specific activities which are often one-sided, although we did come across a number of wind-surfers who over-taxed the structure on both sides. We would be minded to look at what was happening systemically to see if there was a general underlying predisposition to this kind of inflammation.

On balance we think that the best advice we can give you is to visit a BAcC member local to you to see what they make of the problem that you have and by virtue of a face to face assessment offer you a very clear idea of what may be possible. 

As far as cost is concerned, the majority of practitioners outside London tend to charge between £40 and £50 for a first consultation and then £35 to £45 for each subsequent treatment. Sessions can last between thirty minutes and and hour.

We are sorry that we cannot give individual referrals, but if you use the postcode option on our 'find a practitioner' home page facility, as we have just tried, you will find a number of members within a few miles of where you are live, all of whom uphold the high standards for which we stand. 

Page 1 of 4

Post a question

If you have any questions about acupuncture, browse our archive or ask an expert.

Ask an expert

BAcC Factsheets

Research based factsheets have been prepared for over 60 conditions especially for this website

Browse the facts

In the news

Catch up with the latest news on acupuncture in the national media

Latest news