Tennis Elbow & De Quervain's: Not Just "Overuse" — Your Tendons Are Sounding an Alarm｜网球肘·妈妈手：不是"用多了"，是肌腱在"报警"

Jun 21

Twisting a jar lid sends a sharp twinge through the outside of your elbow and your grip gives way; after holding your baby a while, the base of your thumb aches so much you can barely hold the bottle. Different spots, same story: tendons and tendon sheaths crying out under overload.

What Western Medicine Says

Tennis elbow — lateral epicondylitis — hurts at the outer elbow, though the "-itis" is a bit misleading: the problem is mostly chronic overuse and degenerative change where the forearm extensor tendons attach at the lateral epicondyle, not classic inflammation. That's why clinicians increasingly call it a tendinopathy. De Quervain's tenosynovitis ("mom's wrist") hurts at the thumb side of the wrist: the abductor pollicis longus and extensor pollicis brevis tendons rub repeatedly inside their sheath, which narrows while the tendons swell — every movement hurts.

Standard care is stepwise: relative rest, ice, and NSAIDs for symptom relief; elbow or wrist braces to unload the tendons; physical therapy — especially eccentric strengthening — has relatively better evidence among conservative options. Corticosteroid injections ease pain short-term but do little for long-term tendon healing, so repeated shots are generally discouraged. These problems favor people who grip and strain repeatedly: racket-sport players, desk workers glued to mouse and keyboard, new parents carrying babies (hence the nickname mom's wrist), and renovation or housekeeping workers. Most cases ease gradually over months, but flare-ups are common — the sooner you cut the triggers and start rehab exercises, the faster recovery comes. Only the rare few who fail months of conservative care and lose function are considered for surgical release. One caveat: cervical nerve root problems or scaphoid issues can mimic elbow and wrist pain, so the diagnosis has to be sorted out first — not everything is "overuse."

What TCM Sees: Three Patterns

TCM groups these conditions under "bi syndrome" and "tendon injury," with the core mechanism being "pain from blocked flow." Three patterns are common in practice:

Qi stagnation with blood stasis: fixed pain point, worse on pressure, sometimes a cord-like nodule under the fingers; typical of the acute phase or heavier strain with sharper pain. Pain worsens with exertion and eases slightly with rest — but never fully.
Cold-damp obstruction: worse with cold, eased by warmth, marked morning stiffness; common in people working in air conditioning, handling cold water, or outdoors. A pale tongue with white greasy coating is frequently seen.
Liver-kidney deficiency: middle-aged and older patients with recurrent episodes dragging on for months; "the liver governs the tendons, the kidney governs the bones" — undernourished sinews recover slowly and relapse easily. Lower-back and knee soreness often tags along.

Treatment follows the pattern: acute cases focus on moving blood, opening the channels, and relieving pain; cold-damp calls for warming the channels and dispelling cold; chronic, debilitated cases add liver-kidney tonification — treating root and branch together. Pattern differentiation hinges on the pain's character: where it hurts, when it worsens, and what relieves it — those three questions usually settle the pattern.

Typical Presentations

Sharp outer-elbow pain wringing a towel, opening a door, or lifting a cup — pressing the bony bump makes you flinch: commonly qi stagnation with blood stasis
Aching thumb base after carrying the baby or wringing a mop, worse when making a fist with the thumb tucked in, aggravated by cold: qi stagnation with blood stasis plus cold-damp
In your fifties or sixties, elbow pain recurring for over half a year, worse in damp weather, with a heavy, weak arm day to day: liver-kidney deficiency with stasis

How Acupuncture Helps

Acupuncture uses local ashi points (tender spots) plus channel-based point selection — for example, points along the Large Intestine and Lung channels of the hand — sometimes with electroacupuncture or warm needling to strengthen the channel-opening, pain-relieving effect. Research suggests acupuncture may improve pain and function in tennis elbow and tenosynovitis, but studies have methodological limitations and the evidence quality is limited. Acute red, swollen, hot joints, suspected partial tendon tears, or fractures need imaging first to confirm the diagnosis before treatment.

5 Things You Can Do Every Day

Change how you move: cradle the baby on your forearm instead of gripping with the thumb; use your palm heel or a tool for twisting tasks. Be extra careful changing diapers or carrying the baby up and down stairs — don't prop the baby's bottom on one hand.
Brace it: wear a tennis elbow strap or thumb spica brace during work or sport to reduce tendon pull. Place the strap about two finger-widths below the outer elbow bump, snug but not cutting off circulation to the fingers.
Ice vs. heat: ice acute swelling (10–15 minutes at a time); use heat or warm soaks for chronic aching.
Stretch gently: arm straight, palm down, press the back of the hand lightly with the other hand to stretch the forearm extensors, holding 20–30 seconds; move the thumb through gentle opposition. Two to three sets daily, stretching only to a gentle pull — never force it.
Give tendons a deload: pause tennis, knitting, or long phone sessions for 1–2 weeks when pain flares — don't push through it. Talk to your doctor or therapist about short-term immobilization if needed.

Time to See a Doctor If…

Pain persists beyond 2–3 weeks, you keep dropping things, it aches even at rest at night, or the thumb side of the wrist is visibly swollen. Tendon problems degenerate the longer they drag on — early pattern differentiation and early care mean faster recovery.

Book a consultation — let's find the right plan for you.

iHealth Acupuncture Wellness Center | Santa Clara · Menlo Park

拧瓶盖时肘外侧一抽、手一软；抱娃时间稍长，大拇指根部酸得连奶瓶都托不住。疼的位置不同，原理却相似：都是肌腱和腱鞘"不堪重负"发出的信号。

西医怎么说

网球肘的医学名叫肱骨外上髁炎，疼在肘外侧——其实"炎"字有点误导：病变主要是前臂伸肌腱在肱骨外上髁起点处的慢性劳损和退行性改变，并非典型的炎症，所以现在更倾向于叫它"肌腱病"。妈妈手则是桡骨茎突狭窄性腱鞘炎，疼在手腕拇指侧：拇长展肌和拇短伸肌的肌腱在腱鞘里反复摩擦，鞘管变窄、肌腱水肿，动一下就疼。

西医的常规处理按阶梯来：先是相对休息、冰敷、非甾体抗炎药缓解症状；肘部或腕部支具减少肌腱负荷；物理治疗（尤其是离心力量训练）是保守手段中证据相对较好的一项。皮质类固醇注射能短期止痛，但对肌腱长期修复帮助有限，一般不建议反复注射。这类问题好发于需要反复抓握、用力的人群：球拍运动爱好者、长期用鼠标键盘的办公族、抱娃的新手爸妈（妈妈手因此得名）、装修和家政劳动者。病程上，多数人在数月内逐渐缓解，但反复发作很常见；越早减少诱因、开始康复锻炼，好得越快。极少数保守治疗数月无效、严重影响功能者，才考虑手术松解。需要注意：颈椎神经根病变、腕舟骨问题也可能表现为类似的肘腕疼痛，诊断要先分清，不能一概按"劳损"处理。

中医怎么看：三型辨证

中医把这类病归为"痹证""伤筋"，核心病机是"不通则痛"。临床常见三种证型：

气滞血瘀：痛点固定、按压更痛，局部可能摸到条索状硬结；多见于急性期或劳损较重、疼痛较剧者；疼痛在劳累后加重，休息后稍缓，但“缓”不彻底。
寒湿痹阻：遇冷加重、得热稍缓，晨起僵硬明显；长期吹空调、接触冷水、户外作业者多见，舌淡、苔白腻者不少见。
肝肾亏虚：中老年人、反复发作、迁延数月不愈；"肝主筋、肾主骨"，筋骨失养则恢复慢、容易复发，常伴腰膝酸软。

治法随证而转：急性期以活血通络、行气止痛为主；寒湿明显者加温经散寒；久病体弱者兼补益肝肾，标本兼顾。辨证的关键看“痛的特点”：痛在哪里、什么时候加重、什么能缓解——这三问基本能定证型。

典型表现

拧毛巾、开门、端水杯时肘外侧刺痛，按压肘外侧骨突处痛得一跳——气滞血瘀多见
抱娃、拧拖把后大拇指根部酸痛，握拳拇指内收时痛得更明显，遇冷加重——气滞血瘀兼寒湿
五六十岁，肘痛反反复复大半年，阴雨天加重，平时手臂发沉、使不上劲——肝肾亏虚夹瘀

针灸能帮什么

针灸取局部阿是穴（压痛点）配合循经配穴，如手阳明大肠经、手太阴肺经的相关穴位，可配合电针或温针以加强通络止痛之效。研究提示针灸可能改善网球肘和腱鞘炎的疼痛与功能，但多有方法学局限，证据质量有限。急性红肿热痛、疑似肌腱部分撕裂或骨折者，需先做影像检查明确诊断，再决定治疗方案。

日常能做的 5 件事

改动作：抱娃用前臂托、少用拇指发力；拧瓶盖、拧拖把用掌根或借助工具；换尿布、抱娃上下楼时尤其注意，别单手托着娃的屁股。
戴护具：工作或运动时戴网球肘加压带或拇指护腕，减少肌腱牵拉；加压带戴在肘外侧骨突下方约两指处，松紧以不影响手指血运为度。
冷热敷分开用：急性肿痛用冰敷，每次 10-15 分钟；慢性酸痛用热敷或温水浸泡。
拉伸放松：手臂伸直、掌心向下，另一只手轻压手背，拉伸前臂伸肌，每次保持 20-30 秒；拇指做轻柔的对掌活动；每天 2-3 组，拉伸到轻微牵拉感即可，别暴力掰。
给肌腱"减负期"：疼痛明显时暂停打球、织毛衣、长时间刷手机等重复动作 1-2 周，别带伤硬撑；必要时和医生或治疗师讨论是否需要短期制动。

该来看医生了，如果……

疼痛持续 2-3 周不缓解、抓握东西经常脱手、夜间静息时也痛，或手腕拇指侧肿胀明显。肌腱问题拖得越久，退变越重——早辨证、早干预，恢复得越快。

欢迎预约咨询，我们一起找到适合你的调理方案。