What is tennis elbow?
Tennis elbow is a condition when there is pain at the outer aspect of the elbow caused by an injury or tearing of the tendons of the forearm. Since this occurs at the outer aspect of the elbow, which is known anatomically as the lateral epicondyle of the humerus. When this portion of the humerus becomes inflamed, it is known as lateral epicondylitis.
The injury is often caused by excessive use or improper use of the arms and wrist for a long duration. The injury is common in people who play tennis therefore the name tennis elbow. Certain occupations where there is overuse of the arms and wrist and can lead to tennis elbow, so it is not always a sport-related injury.
What are the symptoms of tennis elbow?
The patient experiences pain at the elbow which may radiate down to the forearm and wrist. The pain is worst when the tendons of the forearm are during contraction of these muscles. The patient finds it difficult to use their arm and perform activities such as turning the door knob, shaking hands or holding a firm grip. Persistent pain along with inability to hold grip on objects may be present in chronic and untreated cases.
What causes tennis elbow?
Tennis elbow, also known as lateral epicondylitis is caused due to excessive straining of the tendons of the forearm. The outer edge of the elbow or the lateral epicondyle is the primary site of insertion of the forearm muscles. Excessive use of the forearm muscles can lead to minute tears of the tendons at the elbow. Improper use of the forearm and wrist can also lead to such deformities.
In tennis, repeated use of certain strokes in an improper manner can strain the tendons and therefore cause the condition. Tennis elbow is also common in people with occupations such as plumbing, painting or those tasks which involves constantly turning a screwdriver, cutting hard materials such as meat or even with occupations which involve excessive use of the computer mouse. Tennis elbow deformity is usually seen to occur between in age group 30 to 50 years.
How is tennis elbow treated?
X-rays, MRI scans and EMG studies help to confirm the diagnosis. Tennis elbow usually resolves on its own. Rest is helpful but complete inactivity of the arm is not advised. Wearing splints is also useful to minimize strain on the problem tendons. A cold compresses can help reduce the swelling. Elastic straps of bandages can be used for compression to prevent swelling.
Proper use of the forearm and wrists in a manner so as not to aggravate the injury and allow healing time for the injury is advised in people with occupations which involve excessive use of the forearm and wrist. Strengthening exercises are advised. Braces or straps can be used to reduce the stress on the injured tissues. Braces worn during the night can reduce morning discomfort.
Non-steroidal anti-inflammatory drugs (NSAIDs) are helpful to reduce inflammation and pain while the condition eases. An injection of corticosteroid (hydrocortisone) and lidocaine mixture can be given at the site of the tendon insertion to relieve very severe pain. If at all conservative measures do not yield the desired results, surgery may be advised. Surgical procedures involves removal of the inflamed tissue and if possible repairing the tendon tears. The surgery can also be performed arthroscopically. Post-operative physical therapy and rehabilitation exercises are necessary for good recovery.