Despite its name, tennis elbow or lateral epicondylitis is not unique to tennis players. Tennis elbow is actually the most common condition seen in patients experiencing elbow pain and is believed to be due to small tears in the tendons that attach the forearm muscles to the arm bone at the elbow joint .
The diagnosis of tennis elbow is based on the medical history and physical examination. Additional tests may be ordered to rule out other conditions causing lateral elbow pain.
Treatment for tennis elbow is conservative and generally includes rest, use of a forearm brace, and anti-inflammatory medications.
Tennis elbow occurs when there is a problem with a tendon (called the radial extensor tendon) that attaches to the outer portion of the ulna called the lateral epicondyle, giving tennis elbow the medical name of lateral epicondylitis . This tendon is the attachment point for the muscle that pulls the wrist back (this is called the wrist extension).
It is important to note that tennis elbow is not just a "swelling" of the tendon. Experts believe that repeated use results in microscopic tears in the tendon that do not heal completely. This leads to a degenerative process ("wear and tear") and subsequent pain and discomfort on the outside of the elbow.
Although tennis elbow can occur on its own, there are two groups of people who are particularly vulnerable to developing this condition :
- Athletes – Athletes, especially rocket scientists, are prone to developing tennis elbow. About a third of amateur tennis players have experienced tennis elbow at some point in their careers. In addition to the racket, tennis elbow is found in golfers, fencers, and other sports participants.
- Manual workers: People who work with their hands have a higher risk of developing tennis elbow. Jobs that can lead to tennis elbow include plumbers, painters, gardeners, and carpenters.
In addition to actions that require repetitive grabs and grabs, an injury (in the form of a direct blow to the elbow leading to tendon inflammation) can also cause tennis elbow; although this is a less common culprit.
The most common symptoms of tennis elbow are:
- Sore or burning pain on the outside of the elbow that is worse when grasping or lifting
- The pain begins in the elbow but can later spread to the forearm.
- Weak grip force
The pain associated with tennis elbow usually begins gradually, but it can also appear suddenly. Pain can also be very varied, from very mild to severe and debilitating.
The diagnosis of tennis elbow is based on the medical history and physical examination. Additional tests may be ordered to rule out other conditions causing elbow pain.
In addition to tennis elbow, there are other causes of pain outside the elbow, including joint instability, elbow arthritis, radial canal syndrome , and cervical radiculopathy . These conditions are generally considered if the symptoms are not typical of "tennis elbow" or if the person with suspected "tennis elbow" does not respond to treatment.
Medical history and physical exam.
In addition to questions about the characteristics of your elbow pain (such as location and severity), your healthcare provider will ask you about any potential risk factors, such as whether you have participated in a certain job or sport-related activity or if you have recently experienced an elbow. injury or trauma.
Your healthcare provider will also ask about your medical history, for example, if you have a history of rheumatoid arthritis or a pinched ulnar nerve.
During your physical exam, your healthcare provider will press on your elbow in different places to assess pain. In tennis elbow, tenderness is usually 1 centimeter from the most lateral epicondyle.
Your healthcare provider will also move (flex and extend) your wrist while your arm and elbow are extended to see if this increases or reproduces your pain.
Various tests can be used to diagnose some of the above conditions. For example, while a tennis elbow X-ray should be normal, it may show changes consistent with arthritis of the elbow.
Likewise, an MRI scan is also usually normal, although in some people, the affected tendon may show some abnormal changes. MRI can also be helpful in diagnosing radial canal syndrome.
Sometimes other tests, such as nerve conduction studies and electromyography (EMG) , are done to rule out nerve compression. Blood tests can be used to diagnose inflammatory conditions such as rheumatoid arthritis.
When to contact a healthcare provider
Before starting any treatment, you should discuss the following symptoms with your healthcare professional:
- Inability to carry objects or use the hand.
- Elbow pain that occurs at night or while resting.
- Elbow pain that lasts for several days.
- Inability to straighten or bend the arm.
- Significant swelling or bruising around a joint or arm.
- Any other unusual symptoms
Treatment for tennis elbow involves simple, non-surgical steps, and the good news is that, given enough time, most people respond well.
For most people, one or more of the following treatments are effective for treating tennis elbow:
- Rest and activity modification: Stopping or significantly limiting activities that cause or aggravate the condition (often for several weeks) is a key first step to healing.
- Medications : Under the guidance of your healthcare provider, taking non-steroidal anti-inflammatory drugs (NSAIDs) can relieve inflammation and pain.
- Corset : A tennis elbow brace (a bandage that is placed on the back of the forearm muscle, just below the elbow) can reduce stress on the tendons and muscles.
- Physical therapy: Exercises that stretch and strengthen the muscles of the forearm, as well as various techniques such as ice massage, heat, or ultrasound, can help improve muscle function and speed healing.
- Steroid injection: In some cases, your healthcare provider may decide to inject cortisone (a powerful anti-inflammatory) into the area near the lateral epicondyle.
It's usually best to start treatment in stages, moving on to the next treatment only if it doesn't help relieve symptoms. It is also important to remember that most patients take several months from the onset of symptoms to their disappearance; this is rarely an instant treatment.
A small percentage of patients diagnosed with tennis elbow will eventually require surgery. Generally, patients can consider surgery if more conservative treatments fail after six to 12 months .
Get the word of drug information
Although tennis elbow or lateral epicondylitis is painful and uncomfortable, rest easy knowing that you are not alone. This is a common condition, and with proper time and treatment, the vast majority of people experience tendon healing and relief.