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Tennis elbow is a painful condition in the elbow area that occurs because of the tendon damage in a muscle that stretches the hand and the fingers. These muscles are located on the exterior side of the forearm and are connected to the tendon in the lower exterior part of the forearm bone, which is called lateral epicondyte. In this vertex of the tendons, degenerative and inflammatory changes occur which cause tennis elbow, which is also called lateral epicondylitis in medical terminology.
Causes of this kind of tendon damage are usually chronically stimuli because of frequent and repeated arm movements that are related to certain professions or sports. The cause can also be a one-time trauma, e.g. from carrying a very heavy weight. That is how tennis elbow is usually seen, as a professional disease of plumbers, painters, carpenters, gardeners, people who work on a computer, typists, some musicians, e.g. violinists, so people that often use their forearm.
It is also present in athletes that use a racket. It is considered that around 30% of tennis players at some point in their career get tennis elbow. It is present equally in men and women and in 75% of the cases it occurs in the dominant hand (right for right-handed people).
Tennis Elbow Symptoms
- Pain on the outer side of the forearm below the elbow joint that sometimes spreads down the arm to the hand.
- Pain is caused by bending, lifting the arm or taking and holding light objects, even as a coffee mug.
- Pain usually starts gradually and later it gets stronger. Depending on the severity of the damage, pain can be light and occur some time after the activity; it can last during the activity and get worse; or it can be constant and strong so that it disables the activity.
- Sensitivity to touch in the elbow area.
- Forearm is sometimes hard to get completely straight.
- Tennis elbow rarely causes joint swelling, so in that case you should consider another condition, like arthritis or gout.
Tennis elbow should be differentiated from so called golf elbow or medial epicondylitis, in which it comes to tendon damage in the muscles that are on the inner side of the forearm and that are in charge of bending the hand and fingers. Vertex of their tendon is located on the inner side of forearm bone (medial epicondyte). This condition is rarer and unlike the tennis elbow, the pain occurs on the inner side of the elbow.
Tennis Elbow Diagnosis and Treatment
Diagnosis of these painful conditions is made based on doctor’s examination and determining the painful spots on the elbow joint, and based on the information about the profession and sport activities of the patient. Radiographic of the elbow joint is usually normal.
It is better to start the treatment as soon as possible. While the pain is present, it is important to rest and avoid work and sport activities. Ice compress is applied and medication for pain and inflammation suppression. On the sore arm a so called orthosis can be worn, that keeps the joint in such a position that the sore tendon in the elbow is freed from tension, and fingers and elbow are completely mobile. In more severe cases, for a short period of time injections of corticosteroids can be used on the inflammation spot.
When the pain is decreased, stretching and strengthening exercises of the sore muscles should be done, and they should be continued even when the pain disappears with slow increase of the physical activity. For suppressing the inflammation in tennis elbow, physical therapy is used: electrotherapy, magnetic therapy, and ultrasound.
Treatment usually lasts for weeks, and sometimes months. If after a long treatment the results aren’t satisfying or if the painful episodes keep repeating, surgical treatment is done where the damaged tissue on muscle-tendon structures is removed.
In tennis elbow, prevention measures are also important so repeated episodes could be prevented. If the activities that brought to tennis elbow must be continued, it is needed to “warm up” the arm for at least 5 to 10 minutes with light movements and stretching before starting the activity. It is also important to rest your arm often. Exercises for stretching and strengthening the muscles should be done ordinarily.