tennis elbow: celebrex vs other nsaids

Discussion in 'Health & Fitness' started by topspin64, Jul 16, 2012.

  1. topspin64

    topspin64 New User

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    I developed tennis elbow a few weeks ago. Summer is too precious and want to take a nsaid. Anyone know if celebrex has better efficacy than other nsaids? Also, I'm considering steroid injection. Any comments on that will be appreciated. Thanks.
     
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  2. Chas Tennis

    Chas Tennis Hall of Fame

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    http://tt.tennis-warehouse.com/showthread.php?t=430855

    Playing on an acute tennis elbow injury for more than a few weeks can lead to chronic tennis elbow. See my replies in the above thread.

    In particular

    "1) I read a description by Dr John Cianca in the Repetitive User Injury Handbook of tendon healing after an acute tendon injury. Using Tennis Elbow as an example of tendon healing, he said that playing on it for more than a few weeks may lead to permanently failed healing. The healed part of the tendon may become too disorganized - fibrosis - on the microscopic level. I believe that this may be what happens to healing tendon tissue that is over stressed especially by the same activity that caused the injury. Chronic TE."

    Let's say the cross sectional area of your tendon is A. If you have an acute TE injury you may have torn, for example, 10%A. That partial area of your tendon is now trying to heal. You are continuing to stress it with the same activity that caused the injury to the healthy tendon.

    Have you seen a Dr? You also may not have TE.
     
    Last edited: Jul 16, 2012
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  3. frenzy

    frenzy New User

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    Stop playing tennis now! You might want to take some rest for a few weeks. Keep playing and your elbow will tell you when to stop and it won't be for a few weeks then...count on a couple of months (if it is not too late).
     
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  4. mikeler

    mikeler G.O.A.T.

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  5. SystemicAnomaly

    SystemicAnomaly G.O.A.T.

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    Ice or ice massage after tennis and a couple of other times of the day would be better than medium to long term use of Celebrex or other NSAIDs. Not sure about the efficacy of Celebrex compared to other NSAIDs, but it is quite possible that the health risks could very well be greater. A cortisone injection may or may not help. It is not without serious health risks either.


    .
     
    Last edited: Jul 17, 2012
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  6. SystemicAnomaly

    SystemicAnomaly G.O.A.T.

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    Ice or ice massage after tennis and a couple of other times of the day would be better than medium to long term use of Celebrex or other NSAIDs. Not sure about the efficacy of Celebrex compared to other NSAIDs, but it is quite possible that the health risks could very well be greater. A cortisone injection may or may not help. It is not without serious health risks either.

    Black-box warning for Celebrex & other NSAIDs:
    http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124655.htm
    http://www.drug-injury.com/druginjurycom/2005/06/blackbox_warnin_1.html

    Do you know for certain that it is TE? If so, the 1-handed Bh is the most likely culprit. Try playing tennis with your other arm for a while. It is good for brain development and will give you ailing elbow the rest that it needs.
     
    Last edited: Jul 17, 2012
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  7. Limpinhitter

    Limpinhitter Legend

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    First, I cured my TE by learning to keep a LOOSE GRIP at contact, especially on FH. If your grip is loose at contact, the shock of impact stops in your hand and doesn't transfer to your arm. A loose grip also increases power and clean ball striking.

    Second, I would go with an OTC ibuprofen before taking the risk of Celebrex. Sometimes it can burn your stomach so take it with food.
     
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  8. Avles

    Avles Hall of Fame

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  9. SystemicAnomaly

    SystemicAnomaly G.O.A.T.

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    ^ Good one.

    [​IMG]
     
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  10. charliefedererer

    charliefedererer Legend

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    What is tennis elbow?

    A. Tennis elbow is an injury of the tendons that attach the forearm muscles to the bones at the elbow.


    What kind of injury?

    A. Tendon fibers are torn.


    [​IMG]


    Why is there pain?

    A. The body starts the inflammatory response which involves white blood cells aggregating at the site, and releasing chemicals (cytokines) to attract the type of cell (fibroblast) that will make the protein strands to heal the injury.
    The chemicals also stimulate pain fibers alerting the individual that an injury is present so that they will know to rest the area.

    [​IMG]



    If one continues to play will the injury get worse?

    A. Absolutely. How could it not?
    Continuing to play leads to chronic inflammation that leads to tissue destruction.

    [​IMG]
     
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  11. dman72

    dman72 Hall of Fame

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    I just got back from the ortho and he prescribed celebrex and PT..he said I should use Celebrex as opposed to Ibu (which I normally use) as it is easier on the upper GI and is more effective. He mentioned cortisone shots (did nor recommend at all) and the blood platlet therapy, but he said I seem to be improving well without any of this.

    I almost cancelled the appointment because my arm is at about 90% as opposed to about 30% when I made it 2 weeks ago. I have hit twice since then with my ball machine, concentrating on straight armed forehands and early contact and I have not had the pain increase at all. It looks like I'm finally getting over the hump but I'm still going to take it slow. He was able to find spots in my forearm that still hurt a bit but it's nothing compared to where it was.

    Two weeks ago I was having that fear creep in wondering if I'll end up with long term issues like some people here. I don't envy you. If I had that pain on a regular basis I'd be switching to soccer. :(
     
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  12. SystemicAnomaly

    SystemicAnomaly G.O.A.T.

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    ^ Selective COX-2 inhibitors, such as Celebrex, were thought to be kinder/gentler to the stomach/GI tract since they do not inhibit, the GI-protective COX-1 enzyme. However, it appears that this thinking could be misguided. It appears that Celebrex and other selective COX-2 inhibiting NSAIDs still pose a significant threat to the stomach/GI. Stomach ulcers and GI bleeding are both possible risks. There is also concern that Celebrex and other NSAIDs pose a cardiovasular and possible liver threat as well.

    Short-term use of Celebrex might be warranted if your inflammation is serious and you are not already at risk for disease of the heart, stomach ulcers, GI bleeding, liver, etc.

    http://www.cnbc.com/id/17349356/Pfizer_s_Celebrex_Should_Be_Last_Resort_Heart_Group_Says

    http://www.rxlist.com/celebrex-drug/patient-images-side-effects.htm#sideeffects

    http://www.legalinfo.com/content/celebrex/celebrex-stomach-ulcers-and-gastrointestinal-bleeding.html
     
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  13. Chas Tennis

    Chas Tennis Hall of Fame

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    How do you do a RISK to BENEFIT Analysis for Tennis Elbow?

    I don't know how to do a Risk-to-Benefit analysis for someone with a new case of tennis-elbow-like pain considering whether to play tennis. (The word "new" relates to healing time which may be very short, days?, few weeks ????)

    BENEFIT
    play tennis

    RISK
    X% full recovery
    Y% chronic condition degrades injured joint, tendon, etc., pain - (players with arm braces and some pain)
    Z% show-stopping chronic injury & pain

    With an unknown injury the percentages are poorly known without seeing a Dr. They're improved, but not known with certainty after seeing a Dr. Effectiveness of treatments & surgery?

    I believe that the chance of full recovery is considerably better without the tennis.

    You get similar injuries again and again playing tennis over many years.
     
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  14. dman72

    dman72 Hall of Fame

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    I don't think it's something you can work out on a spreadsheet. It's something you have to feel.

    Every person responds to TE differently, every person responds to treatment differently.

    I haven't called any of my hitting partners in 3 weeks because I know I will stop playing immediately if pain increases. The first week I went to a wall, hit one ball and stopped immediately because pain was sharp.

    I then went 10 days before hitting with a slow feed on my ball machine and was able to hit 2 baskets with only minor pain on one mishit.

    I think I'm one more painless ball machine session away from making calls again. I also think that the forearm work I've been doing is helping to protect the elbow. I went from doing basically no focused forearm work to doing normal and reverse wrist curls, flexbar twists, and using a grip strengthener. .
     
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  15. Baloo

    Baloo Rookie

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    I don't normally comment on TE threads (I have other problems to worry about these days) but my personal experience is as follows:

    I had TE about 3 years ago, started on day with a twinge after playing against a hard hitter and catching a few backhands late. I didn't think much of it and kept playing.

    I have a pretty high pain threshold so I just kept playing, my elbow got worse and I eventually stopped for a few weeks.
    Rest didn't seem to make any difference so, yep you guessed it, I just kept playing (hurt like hell at times) and would ice and stretch etc afterwards.

    After about a year of this it started to improve, I started to apply heat (instead of ice) and it improved some more. Eventually I played one day and bingo...nothing! took about 15/16 months in total. I never had a cortisone shot, i did try every lotion you can get (where I live at least).

    To date I have been 100% TE free for over 18 months. Not saying this is the recommended way to treat TE but in my case it worked.

    Now if only my wrist would come right...
     
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  16. Baloo

    Baloo Rookie

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    Oh yeah, you will learn to run around your backhand at every opportunity.
     
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