It turned out that about three-quarters of people with tennis elbow (who have damage to tendons in their forearm) recovered on their own after about a year.
Okay, maybe not surprising. The next part is though:
There was no significant difference between people who received no medical intervention and spontaneously got better and those who had both steroid shots and physical therapy sessions.
After a year, both groups were doing roughly the same.
The study involved 157 people, from ages 18 to 70. One group received six weeks of physical therapy and two steriod injections (the second group had the therapy and placebo injections). Then the third group got no special treatment.
The most aggressive combo, of physical therapy and steroid injections (to knock down the inflammation), showed a marked benefit at six weeks, no improvement at 12 weeks, and worse symptoms at 26 weeks.
Then, at the one-year mark, this article tells us:
Overall, improvement with physical therapy plus placebo injection or steroid injection was about the same as with no treatment at all.Okay, now here’s my take.
First, steroid injections are dangerous. I really believe these are a deal with the devil: a quick “ah” sensation of relief, at the cost of leaving damaging chemical residue in your joint that weakens it.
As for physical therapy, good physical therapy can be a life saver, but all too often we get bad physical therapy. For example, I recall my own experience when I had knee pain and along the way developed tendinitis diagnosed as golfer’s elbow (which is similar to tennis elbow).
Here’s some of what was done and prescribed:
(1) electrical stimulation (worthless for me, I’m quite sure – but others have had success with this)
(2) stretching exercises (may have damaged the tendon further – how much sense does it make to stretch a cold tendon? Doing so may have created a few microtears in the tissue.)
(3) exercises that were probably too low repetition to stimulate constructive tendon healing.
If that’s similar to the physical therapy that someone gets for tennis elbow, then I wouldn’t be in the least surprised to find out it’s basically ineffective.
However, the right physical therapy can change your life. I devised a program of eccentric exercises, thanks to Doug Kelsey and other sources online, that I’m pretty sure helped me rescue the tendons in both arms. That program I bet would’ve changed some outcomes in this study.
Anyway, for knee pain the right move is not to do nothing and hope it resolves. Don’t take away that message. The point is rather that the solutions we’re directed to, such as conventional physical therapy and high-powered anti-inflammatories, may not be good solutions at all.