Tennis Elbow: Symptoms, Causes & Treatments

Repetitive wrist movements often lead to inflammation and swelling of the tendons connecting the forearm muscles to the elbow. It results in pain and soreness in the elbow that could spread to the arm and wrist. This condition is called Tennis Elbow, medically known as lateral epicondylitis.

The name ‘Tennis Elbow’ does not mean that the condition is limited to tennis players only. It can happen with anyone who overuses or overloads the arm or the wrist.

Symptoms

Persistent pain and ache are the first signs of the condition, especially nocturnal pain. The outer bony bump of the elbow feels tender. There could be morning stiffness and soreness in the forearm muscles. The pain may extend beyond the bony knob. It can radiate outwards to hurt the arms and the wrist. As a result, the grip of the wrist could be weakened. People with this condition are likely to feel the pain more intensely while gripping, lifting, raising the arm, or straightening the wrist.

Similarly, there could be a pain in the outer elbow while turning the doorknob, holding a glass, turning the key, or shaking hands. These are all signs of lateral epicondylitis and require immediate attention. Patients need to visit a certified clinic at the earliest for treatment.

Who are at greater risks of getting lateral epicondylitis?

Certain factors put patients at greater risk. These are:

• Though Tennis Elbow is not age-specific, people aged between 30 to 50 are at greater risk.
• Professionals involved in jobs that require persistent, repetitive motions of the forearms, wrists, etc., are at risk. Carpenters and electricians who need to use screwdrivers regularly may also damage the tendon. Blue-collared workers like plumbers, cooks, etc., are part of this group.
• Sportspersons playing sports where the arm is involved, like holding rackets, swimming, etc., are at increased risk.
• People in professions that involve typing, using a computer mouse, or painting, can get the condition. People who are fond of gardening or knitting are also at risk.
• Weightlifters can also experience minor tears to the tendon, causing pain to the region.

Causes

The primary cause behind the condition is repetitive movements causing the forearm muscles to contract. The overuse and continuous tugging and twisting motion of the arm leave the tendons and the muscles stressed. This is why people who play tennis, squash, or fencing are prone to develop this disease.

The other cause of lateral epicondylitis is when the arm hits directly against a hard surface, like a concrete wall.

Diagnosis

• Diagnosing involves a detailed examination of the elbow region. Physical examination usually involves flexing the arms to identify the exact location of the pain. The physician feels the affected arm, joints, nerves, bones, and muscles.
• X-rays may be advised to rule out other issues like damaged tissue or bone.
• Besides reviewing the patient’s past medical history, questions are asked on their profession, recreational and sporting activities, other medical problems to understand if the pain could be because of previous injuries.
• The doctor might suggest a CT scan or MRI, or even blood tests to dismiss other medical conditions in rare cases.
• Sometimes, patients might be asked to go in for nerve studies to check if the radial nerve is entrapped or not.

Treatment

Tennis Elbow can heal effectively. Patients need to give rest to the elbow. Some of the treatments advised by the doctor include:

• Ice pack – It helps in minimizing inflammation, swelling, and pain. Icing should be done regularly for two to three days, every three to four hours. Every icing session should be for about twenty to thirty minutes.
• Elbow strap – It is a medical accessory that helps safeguard the tendon to prevent further damage. A counterforce brace, like a strap worn around the forearm, should be used to relax the affected area.
• Non-steroidal anti-inflammatory drugs – NSAIDs like aspirin and ibuprofen can be taken to combat the pain. These medicines, however, have side effects. Thus, these drugs should be orally taken only when advised by the physician.
• Injection – It can be used for temporary pain relief to the area.
• NSAID Creams – These are suggested for rubbing over the area.
• Physical Therapy – A qualified physiotherapist recommends exercises to ensure the return of flexibility to the arm and for strengthening the muscles.
• Massage & Soft Tissue Therapy – It helps a lot, especially ice massage is recommended for faster healing.
• Hot bath – It can be advised by the doctor, depending upon the condition of the affected area.
• Non-invasive treatment – Your doctor may advise methods like Plasma Therapy. In this procedure, platelet-rich plasma is injected into the affected area to speed up the natural healing process. Another common procedure advised by the physician is Shockwave Therapy. In this method, sound waves are used for microtrauma to naturally encourage the body to heal the tendon.
• Surgery – In most cases, all the above in-office treatments offer productive results. However, if the patient does not feel much difference, the doctor would suggest surgery. A portion of the stressed tendon is removed, allowing the rest of the area to heal. It is crucial to consult with the best orthopedics in town for the right treatment.

The recovery process may be slow or fast depending on the patient’s healing rate and the damage. In most cases, patients recover completely after about twelve months of conservative treatment. It is best to let the affected area heal completely before using it like before.

Prevention

Since lateral epicondylitis is a condition that occurs due to overuse, it is important to give the elbow rest when in pain. Patients are also advised to do the below tasks:

• Check their equipment to ensure that they use the right-sized and right-weighed tools.
• Check the posture while using the equipment as a wrong stance or grip can pressurize the tendon. You could try switching hands too.
• Start with rehabilitation exercises or occupational therapy can help prevent further injury. Let a professional assist you learn the right way of doing the exercises. Every physical session should begin with a warm-up activity. The application of an ice pack helps avert inflammation of the tendon.
• Get back to their previous activity level, gradually building up.
• Never end the treatment on their own. It should be continued as per the prescribed period determined by your doctor.
• Schedule an appointment with the physician, if the pain persists or returns after treatment is over.

Why 7DMC?

We are one of Dubai’s most-trusted Sports Medicine & Orthopedic clinics. Our team is versatile, proficient, and qualified from some of the world’s best medical institutes. Our state-of-the-art multi-specialty clinic in the heart of Dubai is equipped with cutting-edge equipment and medical devices. We believe in working one-to-one with our patients for their speedy and holistic recovery.

References 

https://www.webmd.com/fitness-exercise/tennis-elbow-lateral-epicondylitis#1

https://www.cigna.com/individuals-families/health-wellness/hw/medical-topics/tennis-elbow-hw225372

https://www.emedicinehealth.com/tennis_elbow/article_em.htm#how_do_health_care_professionals_diagnose_tennis_elbow

https://www.medicinenet.com/tennis_elbow_symptoms_causes_and_treatments/article.htm

https://www.medicalnewstoday.com/articles/175848#treatment