Tennis elbow pain can be slow to heal

Dear Dr. Roach: I’m a 75-year-old man who is quite active in many sports, including tennis. About six weeks ago, I developed pain in the outside of my elbow, which the internet tells me is lateral epicondylitis. I’ve never had an injury, including fractures, that is so persistent. I seem to be no closer to resuming my sports activities. Could you write about the condition and what treatments have the best chance of success?

R.R.

Answer: Lateral epicondylitis (“tennis elbow”) is a common cause of elbow pain, especially in athletes, so the internet might be right. However, there are at least a dozen other conditions that can mimic lateral epicondylitis, so I recommend a visit to your friendly physician to be sure.

If your doctor agrees with your diagnosis, the treatment regimen has several parts. The first is to stop the activity causing the problem in the first place. Often, improper body mechanics (or in tennis, an unsuitable racquet) cause the inflammation, and changing your movement will help prevent the problem. In any event, you’ll need to stop or slow down for some weeks. If you do keep up the activity, icing afterward will help.

Second, get a counterforce brace, which is pretty effective. You can buy one at your local pharmacy or online. Anti-inflammatories like ibuprofen are helpful. Finally, physical therapy for mobility and strengthening complete the initial treatment, and this regimen is effective for most people. If not, it’s time to reconsider the diagnosis, and perhaps get some additional testing or visit an expert, such as a sports medicine physician.

Dear Dr. Roach:

I am a 62-year-old female. I have been on Enbrel injections weekly for 12 years due to rheumatoid arthritis. I received my first COVID-19 vaccine on Dec. 23, 2020, and second vaccine on Jan. 13, 2021. On Jan. 24, despite wearing a mask, I tested positive for COVID-19 after visiting my parents, who had the infection. I had no symptoms, but quarantined for 14 days. I went to an outdoor gathering on July 17 and was alerted that an individual had COVID-19. I tested on July 22 and was again positive. I had no symptoms but quarantined for 10 days.

Yesterday, I took an antibody test that is 91% accurate. I was negative for all antibodies. I will be taking a booster shot soon. Do you have any additional advice?

L.S.C.

Answer: People with immune system disease or who are taking medications that suppress the immune system do not have reliable protection either from getting COVID-19 or from getting the vaccine. While the vaccine may be part of the reason you had no symptoms either time you had COVID-19, you are relying on the people around you to not be sick.

The delta variant of COVID-19 is very contagious, and masking and physical distancing are also only partly effective. The best advice I have is to get your third vaccine (and maybe a fourth in six months), but make as sure as you can that all your close contacts are vaccinated. Again, the vaccine isn’t perfect, but having your contacts vaccinated will greatly reduce the amount of COVID-19 you are exposed to, since the vaccine not only dramatically reduces infections but also seems to reduce the infectivity of people who are infected, compared with unvaccinated people with COVID-19.