Tennis Elbow

 Tennis elbow, is a condition that causes pain on the outside of the forearm in the elbow region.

It is a common condition, an injury to the tendons that join the forearm muscles (the extensor carpi radialis brevis (ECRB) to the outside of the elbow. This condition occurs when there is inflammation or degeneration in these tendons.

Image showing distribution of pain in the elbow

Symptoms of Tennis Elbow

  • plus-+-svg Pain associated with the tennis elbow comes on gradually.
  • plus-+-svg It starts as a mild recurring pain in the outer elbow which becomes intense and causes discomfort and weakness when moving the forearm. The pain worsens with lifting or bending the arm.
  • plus-+-svg If left untreated, the pain will spread down to the wrist and start hurting even at rest.
  • plus-+-svg Tennis elbow can also be due to acute injury, in which the area around the elbow swells up along with pain immediately after a sudden injury.

Causes of Tennis Elbow

The tennis elbow is most commonly a chronic injury. It occurs when due to overuse and damage to the forearm muscles, the tendons and the other muscles surrounding the elbow by doing repetitive movements. These, in turn, causes inflammation or mild tears in the tendons.

Here are some common activities that cause tennis elbow:
  • plus-+-svg Playing racquet sports like tennis, squash and badminton
  • plus-+-svg Sports that involve full arm extension and throwing (overarm throwing)
  • plus-+-svg Lifting weights frequently
  • plus-+-svg Activities that involve frequent bending of the elbow
  • plus-+-svg Repetitive hand and wrist movements in activities like typing
  • plus-+-svg Occupations involving repetitive hand grasping like bricklaying
  • plus-+-svg Regular use of hand tools in occupations such as painting
Apart from these activities, ageing or degeneration is another major cause of tennis elbow.

Diagnosis of Tennis Elbow

Diagnosis of tennis elbow begins with history taking and a thorough physical examination of your elbow for swelling and tenderness. Your doctor will bend and move your arms, elbow and wrist to find if the pain relates to your symptoms.

In addition, the doctor may suggest imaging tests like ultrasound scanning to confirm the diagnosis. These tests also help diagnose the severity of the tendon and muscle damage around your elbow.

Treatment for Tennis Elbow

Usually, the tennis elbow heals on its own with time. However, you may have to rest your arms by limiting activities that put a strain on your tendons. If your symptoms don’t improve, you can treat tennis elbow with the treatments listed below.
  • plus-+-svg Medication:- You can reduce the inflammation and ease the pain by taking painkillers and Nonsteroidal anti-inflammatory drugs(NSAIDs). Besides, there are several topical NSAIDs as sprays, gels and creams that you can apply over the affected area to relieve pain faster. Then there are also cortisone or platelet-rich plasma injections to ease the pain. Dry needling is also helpful. With medication, your doctor may also suggest you wear a tennis elbow strap for a short time. You have to wear it over the forearm just below the elbow to clamp and reduce the tension on the damaged tendon.
  • plus-+-svg Physical Therapy:-Physical therapy involves exercises like stretches to improve the strength and flexibility of the forearm muscles and tendons. These therapies also improve blood circulation for faster healing. Wrist extension, towel twist and finger stretch are some basic exercises that improve tennis elbow. Massage also reduces inflammation and eases the pain.
  • plus-+-svg Shock Wave Therapy:-Shock Wave therapy is an effective treatment that shows good results for many. It involves giving high-energy shockwaves in the affected area near the elbow to relieve inflammation and restore movements. However, it causes minor side effects such as bruising and reddening of the skin. Some may also experience nausea.
  • plus-+-svg Surgery:- If none of the above treatments helps, your doctor may recommend surgery. Surgery for tendon repair can include removal of the damaged tendon linings. A few days after surgery, your doctor will suggest physiotherapy to regain strength and movement.

Frequently Asked Questions (FAQs)

As tennis elbow occurs with regular activities or recreational sports, it’s not easy to prevent it. However, if you start experiencing pain or discomfort in the elbow region, get professional help to change the technique or movement that puts strain on your elbow, wrist and forearm. You can also try changing the equipment, like using lightweight tools to avoid straining.
It usually gets better with rest and self-care. You can also try ice compression along with anti-inflammatory medicines to relieve pain and inflammation. Most importantly, avoid doing activities that strain your tendon in the elbow region. If the pain doesn’t subside with self-care and rest, you must seek medical care for proper medical treatments.
The pain with tennis elbow is usually associated with the outside of the elbow. You will feel pain, swelling or tenderness in the elbow region. Pain occurs precisely in the area where the tendons of the forearms attach to the outside of your elbow. However, you may also feel pain in the forearm and wrist.
During the initial stages of tendon inflammation, you may not feel any pain. With time, you will start to feel mild pain and discomfort along the outside of your elbow. Slowly, the pain will spread down to your forearm and wrist, affecting your daily life activities like using a door key or holding a cup. This eventually leads to pain even at night.
Yes, it heals on its own with time and rest. It may take anywhere from twelve months to a year or sometimes more than that. However, a full recovery is only possible by stopping the activity that causes inflammation. Rest is the mainstay of treatment but this can take a long time. If that is not possible, consult a doctor right away.

Conclusion

Tennis elbow is an injury that can affect anyone. However, without proper medical diagnosis and treatment, you can develop a chronic pain which is difficult to resolve without intervention.
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