Tennis elbow (or lateral epicondylitis) is an excruciating condition that results from overusing the extensor muscles in the arm and forearm, mainly where the tendons connect to the bony projections on the outer (lateral) part of the elbow. These muscles are responsible for gripping, twisting, and lifting items, all of which place stress on the lateral epicondyle. As a result, wrist or hand movements can trigger pain in the elbow.
Symptoms
Tennis elbows can develop from prolonged wrist and hand use, such as working on a computer or operating machinery, or improper technique in sports like tennis. It affects both athletes and non-athletes, with men being more commonly affected than women. Also, it is most prevalent in individuals aged 30 to 50.
Common symptoms involve:
Pain radiating to the forearm and wrist.
Trouble performing everyday tasks like holding a coffee cup or turning a doorknob.
Difficulty engaging in gripping activities
Pain that worsens when using the wrist and hand to open jars, lift items, or tightly grip things like a fork or knife.
Elbow stiffness
Wrist, forearm, or hand weakness
Causes
Playing tennis and other racquet sports can trigger tennis elbow, particularly in beginners or those returning to the sport after a long period. However, around 95% of all cases are unrelated to tennis.
Common causes are:
Repeated or strenuous forearm use in activities like gardening, throwing sports, and manual labor.
Occupational risks for bricklayers, butchers, painters, carpenters, and plumbers.
Sudden forceful movements (though the condition usually occurs gradually due to repetitive stress)
The extensor carpi radialis brevis (ECRB) muscle plays a key role in stabilizing the wrist when the arm is extended. Overuse of the ECRB can cause tiny tears in the tendon where it attaches to the lateral epicondyle, leading to tendonitis and tennis elbow-related pain.
Diagnosis
At The Joint Pain Clinic, we usually diagnose tennis elbow through:
Medical history:Talking about the symptoms and possible causes of the problem.
Physical examination: Evaluating wrist and elbow range of motion, pain sites, and specialized orthopedic testing.
Imaging tests: Sometimes, we can perform an ultrasound to determine the degree of tendon damage and rule out other disorders.
Treatment Options
Most individuals with tennis elbow experience relief by resting the affected arm and avoiding movements that cause discomfort. Taking pain relievers, applying ice packs, and using topical anti-inflammatory treatments can also help alleviate symptoms.
We may also recommend the following treatment options:
Splints and supports: In cases of severe pain, specialized braces, strapping, or splints may be applied temporarily to provide support.
Steroid injections: Injecting steroids into the elbow can help reduce inflammation and alleviate pain. Additional treatments can be administered after three to six months, but no more than 3 injections in the same spot.
Shockwave therapy: This treatment utilizes high-energy sound waves, which are delivered to the elbow through the skin using specially designed equipment. The number of sessions required depends on individual symptoms, with some patients experiencing relief after just one session, while others may need multiple treatments for optimal results.
PRP injections: Platelet-rich plasma (PRP) is an advanced and effective treatment for tennis elbow, available at our clinic. This procedure involves taking a sample of your blood, processing it to concentrate the plasma and platelets, and then injecting it into the elbow. This promotes faster healing and may eliminate the need for surgery.
Surgery: In some cases, surgery may be necessary for tennis elbow if symptoms fail to improve with non-surgical treatments. The procedure involves making a small cut on the outer elbow to free the tendon attachment from the bone. It can be done under local anesthesia with sedation or as a day-case procedure under general anesthesia. Most patients can return home the same day and resume normal use of their elbow within a few weeks.
