Healing tendonitis with TCM: golfer's elbow and tennis elbow

Tendonitis is irritation of a tendon, the tough cord that attaches muscle to bone. In the elbow it can make lifting a kettle or turning a doorknob surprisingly hard. Sport is only one cause. Painting, hammering, raking, typing, using a mouse, lifting children and playing an instrument can all strain the same forearm tendons.

What is the difference between golfer's elbow and tennis elbow?

Both involve the tendons of the forearm muscles where they attach at the elbow. The difference is the side:

• Tennis elbow (lateral epicondylitis) affects the outside of the elbow, where the muscles that lift the wrist and fingers attach. It is usually felt on the top and outer side of the forearm.
• Golfer's elbow (medial epicondylitis) affects the inside of the elbow, where the muscles that bend the wrist and fingers attach.

Doctors and physiotherapists increasingly call these problems "tendinopathy" rather than "tendonitis", because in long-standing cases the tendon is often more worn and overloaded than truly inflamed. The practical point is the same: the tendon has been asked to do more than it can recover from.

What are the symptoms?

Common signs include:

• Pain and tenderness on the outside (tennis elbow) or inside (golfer's elbow) of the elbow
• Stiffness in the arm, and pain when making a full fist
• Difficulty carrying or lifting objects, even light ones like a cup
• Trouble fully straightening the forearm
• A weaker grip

Why check the neck and shoulder?

The elbow is often where the pain shows up, not the only place the problem sits. Tight or poorly firing muscles in the neck, shoulder and upper back can change how the arm moves and put extra load on the forearm tendons.

Dalibor uses a "motor point" assessment to check the neck, shoulder and arm muscles for this kind of imbalance. If muscles higher up the chain are not firing properly, leaving them untreated may slow recovery and make the elbow more likely to flare again. If your shoulder or neck is involved too, see our pages on shoulder pain and neck pain.

How can you lower the risk?

A few habits help:

• Warm up before physically demanding activity, including some gentle stretching.
• Build up slowly with new sports, jobs or projects, and take breaks when you feel over-exerted.
• Limit long runs of the same repetitive motion, and switch hands or tasks when you can.
• Check your set-up: racket grip size, tool handles, keyboard and mouse position.
• Light resistance training can strengthen the forearm muscles and tendons over time.
• Do not ignore pain. Pain that builds each time you do an activity is a signal to change something.

What should you do when it flares?

For a fresh flare-up, a common first approach is the RICE method:

• Rest from the movements that provoke the pain
• Ice for short periods in the first day or two
• Compression with a bandage or forearm strap
• Elevation when the area is swollen

Complete rest for too long is not ideal either. Tendons usually recover better with gradual, controlled loading, so once the first flare settles, gentle strengthening exercises often become part of the plan. A physiotherapist can guide this, and it fits well alongside acupuncture.

Can acupuncture help elbow tendonitis?

It may. Some studies suggest acupuncture may reduce tennis elbow pain in the short term. Thin, sterile, single-use needles are placed around the elbow and in related areas of the forearm, shoulder and neck. The aim is to improve circulation to the area, relax overworked muscles and support the body's own repair processes.

The goal is not to mask pain but to help the tendon and surrounding muscles work normally again. Some people also try electro-acupuncture, where a gentle current is added to the needles. If you take pain medication, keep taking it as your doctor advised.

Can Chinese herbs help?

In TCM, herbal medicine is used to support soft tissue recovery. The choice of herbs and the dose vary from person to person and depend on the stage of recovery, so Dalibor decides this with you during treatment. Tell us about any medications, blood thinners in particular, and whether you are pregnant.

What happens at a first visit?

At your first visit, Dalibor Covic, R.TCMP, assesses the elbow, forearm, shoulder and neck, explains what he finds and gives you a first treatment and a plan. Your first visit is an initial examination ($110, about 60 minutes) followed by your first acupuncture treatment ($120). If elbow pain is getting in the way of work or sport, you can book a first visit at our clinic near Hwy 401 and Dixie Rd in Mississauga.

Common questions

Do I have to play tennis or golf to get tennis elbow or golfer's elbow?

No. Most people with these problems do not play either sport. Typing, using a mouse, carrying, lifting, gardening and tool work are common causes.

How long does elbow tendonitis take to settle?

It varies widely. Mild cases can settle in a few weeks with rest and load changes, while long-standing ones can take months. We review your progress after a few sessions and adjust the plan.

Should I see my doctor as well?

Yes, especially after a fall or injury, if the elbow is swollen, hot or looks deformed, if you have numbness or weakness in the hand, or if pain keeps getting worse.

This page is general information, not medical advice. Acupuncture works alongside the care you get from your family doctor. If your symptoms are new, severe or getting worse, see your doctor first.