TENNIS ELBOW (LATERAL EPICONDYLITIS)
Tennis elbow, or lateral epicondylitis, is a type of tendinitis that causes pain in the elbow and arm, and is the most common reason that people see a physician for elbow pain. Tennis elbow is an overuse injury that causes inflammation to the tendon that joins the forearm muscles on the outside of the elbow. Despite its name, you do not have to be an athlete, or play tennis, to develop tennis elbow. Any repetitive gripping activities, especially movements using the thumb and first two fingers, can contribute to tennis elbow.
Tennis elbow affects the tendons attached to the muscles on the outer (lateral) side of the elbow, which work to extend the wrist backwards and straighten the fingers. In contrast, golfer’s elbow affects the tendons attached to the muscles on the inner (medial) side of the elbow, which work to flex the wrist and contract the fingers when you grip something.
COMMON CAUSES OF TENNIS ELBOW
Tennis elbow usually develops slowly over time due to repetitive stress placed on the tendons on the outside of the elbow. Continuous stress can eventually cause microscopic tears in the tendons that connect your forearm muscles to the bones in your elbow, resulting in inflammation and discomfort.Activities such as tennis, weight lifting, gardening, throwing, and swimming can all cause damage to the tendons in the elbow. People with jobs or hobbies that require repetitive arm movements or gripping that require turning the wrist can also develop tennis elbow over time. This would include hair stylists, carpenters, plumbers, knitting, painting, and more.
COMMON SYMPTOMS OF TENNIS ELBOW
Symptoms of tennis elbow include pain and tenderness in the bony knob on the outside of your elbow. The injured tendon connects to the bone where this knob is located. Pain from tennis elbow can radiate into the upper and lower arm as well. Even though the damaged tendon is located in the elbow, painful symptoms are likely to occur when doing things with your hands. Patients often experience painful symptoms when:
- Lifting objects
- Gripping an object, such as a tennis racket
- Opening a door or shaking hands
- Raising your hand or straightening your wrist
To diagnose tennis elbow, your physician will first conduct a physical exam to assess symptoms such as swelling and tenderness in the elbow. The physician will also perform a series of movements to check your arm, wrist, and elbow to try and replicate any painful symptoms. X-rays help determine the condition of the elbow and can help rule out other potential problems. An MRI may also be needed in order to see of soft tissues (muscles, ligaments, tendons) within the elbow.
Tennis elbow, or lateral epicondylitis, is usually treated effectively with rest. The R.I.C.E. method is a simple self-care technique that helps reduce swelling, ease pain, and speed the healing process.
- Rest: when you begin experiencing pain and discomfort in the elbow to help reduce inflammation and give the tendon time to heal
- Ice and Cold Packs: can help reduce pain and swelling. Ice should be applied for about 15 minutes several times a day
- Over-the-counter anti-inflammatory medication: such as Ibuprofen (Advil, Motrin) and naproxen (Aleve) can ease mild to moderate pain and reduce inflammation
- Braces and Splints: supportive bracing on the forearm can help take pressure off the tendons in the elbow. A wrist splint worn at night can help rest the muscles and tendons in the lower extremities
Your physician my also recommend a corticosteroid injection to treat painful symptoms and reduce inflammation in the elbow. Physical therapy can also help reduce pain, speed the recovery process, and reduce the risk of reinjuring the elbow.
Conservative treatments usually work for tennis elbow. However, if painful symptoms remain after six to twelve months of conservative treatment, you may need surgery. The surgical procedure for tennis elbow involves removing any damaged muscle and reattaching healthy muscle back to the bone. Physical therapy will be an important part of the recovery process. Full recovery time may take three to six months.