Who is the best person to see for nonoperative treatment of tennis elbow? I'd really like to avoid surgery if at all possible.
Many people begin with physical therapy and learn how to modify activities to avoid aggravating the irritated tissue. Sometimes activity restriction is required. This means you may have to stop doing some activities or motions and give the joint and surrounding soft tissues a rest. The therapist may suggest using bracing and/or heat treatments such as ultrasound and laser therapy. Activities, movement, and exercises to improve proprioceptive (joint sense of position) techniques may be helpful. Other nonoperative approaches used with some success have included manual therapy and extracorporeal shock wave therapy (ESWT). Manual therapy is a hands on technique provided by the physical therapist. It involves moving soft tissue and bone to restore normal alignment and tissue tension. Shock wave therapy is thought to work by causing microtrauma to the tissue that is affected. The body responds to the microtrauma with a healing response. The result is blood vessel formation and increased delivery of nutrients to the affected area. The final outcome is pain relief from the tendinopathy. There are other treatment ideas that have not been tested yet. These are on the integrative side of medicine and provide an alternative way to approach the problem. Reiki, acupuncture, craniosacral therapy, BodyTalk, Healing Touch, and even hypnosis have been used with some success.