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Article written and designed by Cosimo Simeone, Msc, PgdDip, Bsc, Physiotherapist

Tennis elbow, or lateral epicondylitis, is a common issue with the outer part of the elbow. It happens when you use your forearm and wrist too much, causing pain and tenderness in the bony bump on the outer side of the elbow. It’s not just for tennis players, anyone doing repetitive gripping or wrist movements can get it.

The main cause is using forearm muscles too hard, leading to tiny tears in the tendon at the lateral epicondyle. Everyday things like using hand tools or a computer mouse can bring it on.

The main symptom is increasing pain, especially when you grip or lift things. You might also feel stiffness in the elbow and a weaker grip. But people often think it’s just a temporary strain.

Getting a quick and accurate diagnosis is crucial. Doctors do physical tests, look at your medical history, and might use imaging studies to be sure it’s tennis elbow and not something else.

This guide covers all things tennis elbow, what causes it, the signs, how it’s diagnosed, and ways to treat it. Whether you play sports, work in an office, or just like DIY projects, knowing about tennis elbow helps you fix it and keep your elbow feeling good.

Signs and Causes:

The signs show up slowly, and the pain can increase over weeks and months. Here’s what you might feel:

  • A burning or painful sensation on the outer part of your elbow that might go to your wrist. This can be worse at night.
  • Pain when you twist or bend your arm, like turning a doorknob or opening a jar.
  • Feeling stiff or having pain when you straighten your arm.
  • Your elbow joint might swell, and it could hurt when you touch it.
  • It might be hard to grip things, like a racket, wrench, pen, or even someone’s hand.

Tennis elbow usually happens when we use our arm too much or strain our muscles. We’re not exactly sure why it happens, but sometimes, doing a lot of movements that tense the forearm muscles, like straightening and lifting the hand and wrist, can lead to the problem. This can make the fibers in the tendon that connects the forearm muscles to the bony bump on the outer elbow break down.

Things we do in our daily life that might cause tennis elbow include:

  • Playing racket sports, especially if we use a not-so-good backhand technique.
  • Using tools for plumbing.
  • Doing painting jobs.
  • Screwing things in.
  • Chopping up food for cooking, especially meat.
  • Using a computer mouse a lot.

Sometimes, tennis elbow can also happen if we get injured or have a problem with the body’s connective tissues.

Tennis Elbow Risk factors

Some things make it more likely for someone to get tennis elbow:

  • Age: It can happen to anyone, but it’s more common in adults between 30 and 60 years old.
  • Job: People with jobs that involve doing the same wrist and arm movements over and over, like plumbing, painting, carpentry, butchery, or cooking, have a higher chance of getting tennis elbow.
  • Certain sports: Playing racket sports increases the risk, especially if we don’t use good form or good equipment. Playing for more than two hours a day also makes it more likely.
  • Other things that can make it more likely include smoking, being too heavy, and certain medicines.

Diagnosis:

Finding out if you have tennis elbow involves visiting a physiotherapist. He will ask about your health, medical history, and the things you do every day like work etc or everything that might trigger or cause your pain. He will also check your elbow by pressing on certain areas to see if it hurts.

Sometimes, he might suggest pictures like X-rays or magnetic resonance imaging (MRI) to get a better look inside. It’s important to tell in the diagnosis when the pain started, what makes it worse, and if you tried anything to feel better before.

The physiotherapist will use this information to figure out the best way to help you feel better. Early discovery is important because it helps to start the right treatments early, giving you a better chance of getting better. You can book an appointment with our expert physiotherapists here, for personalized assessment and treatment.

Tennis Elbow Treatments options:

Tennis elbow often improves on its own, considered a self-limiting condition. Typically lasting between 6 months and 2 years, about 90% of individuals recover fully within a year.

The primary step is to give your injured arm a break and avoid the activity that triggered the issue. Simple remedies include applying a cold compress, like a bag of frozen peas wrapped in a towel, to the elbow for a few minutes multiple times a day to help with pain.

Furthermore immobilization of the arm in a neutral and straight position could help to relax the tendon affected. You can find some useful tutor here, use it for 20 minutes up to 3 times per day.

If you have tennis elbow, it’s crucial to stop or change activities that strain the affected muscles and tendons. If your job involves repetitive arm movements, you might need to take a break from these tasks until the arm pain improves. Consider discussing potential changes with your employer to avoid activities that worsen the pain.

Mild pain and inflammation caused by tennis elbow can be eased with painkillers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Also CBD as topic cream is effectively to treat musculoskeletal pain.

But remember these solutions are to reduce the pain, but they are not acting against the causes. Understanding the causes and acting to eliminate them is the way to effectively treat your pain

For more severe or persistent pain, a physiotherapist can use techniques like massage and exercises to alleviate pain, improve movement, stretch and strengthen forearm muscles. Steroid injections, though offering short-term relief, may be considered when other treatments are ineffective, while shockwave therapy and platelet-rich plasma (PRP) injections are emerging options with varying degrees of effectiveness.

Surgery Options:

In extreme cases, where pain is severe and persistent, surgery might be recommended to remove the damaged part of the tendon.

Types:

Advanced Arthroscopic Techniques
Fancy-sounding arthroscopic methods are a kind of treatment for tennis elbow that don’t need big cuts. Instead, a small cut near the elbow is made, and a special tool with a light and tiny camera is put in. This helps the doctor see what’s going on inside. They use special tools to fix the tendon or clean things up. The good thing is, this way, you get better faster and feel less pain.

Tendon Reconstruction
When tennis elbow messes up your tendons a lot, the doctor might need to do something called tendon reconstruction. At Penn, doctors have cool ways to do this, making your elbow work better, making it stronger, and hurting less.

Open Tendon Repair
If the tendon is really torn or the tissue is badly damaged, the doctor might decide to do a big repair with open surgery. This is for trickier cases and might involve more than one thing done at the same time. It’s like a bigger fix for a more serious tennis elbow problem.

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