Elbow Pain and Computer Use

Physical therapists can help patients with tennis elbow manage their symptoms at home and at work. This report gives the second batch of results after a physical therapy (PT) program for tennis elbow. The first study reported on short-term results after eight weeks. This report offers details after six months.

Sixty (60) patients from nine sports clinics and two physical therapy clinics were included in the study. All patients had lateral tennis elbow with pain along the outside of the elbow. Pain was made worse by gripping or extending the wrist.

Before the study was started each patient was asked questions about pain and function. A careful exam was done by the physical therapist. The first study reported on results after eight weeks. Patients were contacted again by mail or phone at the end of six months.

They found some risk factors that might predict who will get better and who won't. Repetitive work tasks was one. Female gender was another. Nerve symptoms with neck motion and neck pain added two more risk factors. Women who had both neck signs and a repetitive job were more likely to have a poor outcome.

Work was often the cause of the injury, but very few patients saw the link between the two. None of the men reported work as part of the problem. Only 18 percent of the women reported a work-related injury. A key factor linked to long-term prognosis was the amount of time spent using the forearm. Patients working 25 hours or more per week at the computer were at increased risk for poor outcome after treatment for tennis elbow.

The authors make several suggestions for PTs treating patients with tennis elbow. First, the therapist must be aware of the patient's work tasks. This is true even if the patient hurt the elbow while playing sports or some activity outside the work setting. Treatment should include a visit to the patient's work place. If that can't be done, the patient should be shown on a computer station at the PT clinic how to reduce risk of injury at work.

More study is needed to find out if changing work place activities can speed up recovery in patients with tennis elbow.

References: Esther J. Waugh, BScPT, MSc, et al. Computer Use Associated with Poor Long-Term Prognosis of Conservatively Managed Lateral Epidondylalgia. In Journal of Orthopaedic & Sports Physical Therapy. December 2004. Vol. 34. No. 12. Pp. 770-780.