Definition and Overview

Tennis elbow refers to a condition that causes pain or soreness of the elbow, particularly the outer part. This occurs when the tendons connecting the forearm muscles to the elbow gets damaged. If left untreated, the pain may spread to the wrist and may make moving your hand for simple activities quite painful.

Causes

Tennis elbow can be caused by several reasons, but in most cases, strain from overuse is what ultimately damages the tendons, creating tiny tears that may cause pain after a while. It is possible that these tears have been around for some time before you felt the symptoms. If you engage in any activity wherein you have to twist your arm repeatedly, the greater your risk of getting tennis elbow.

Tennis players are susceptible to this condition, with up to 50% of tennis players experiencing this condition during their careers, hence its name; this, however, does not mean that the condition only affects tennis players. As a matter of fact, out of all cases of tennis elbow, only 5% of them are actually caused by playing tennis.

Anyone can get tennis elbow, especially those whose work requires the same movement from the arms, such as bowlers, baseball players, professional cleaners, carpenters, mechanics, assembly line workers, landscapers and gardeners, as well as golfers, among several others. It is also more common among people between 30 and 50 years of age.

Key Symptoms

The main symptoms of tennis elbow include:

  • Pain outside of the elbow that slowly increases (pain may also develop suddenly, but this is rare since the tendons have to experience a certain level of damage before they cause pain)
  • Pain that gets worse when squeezing, shaking, or exerting effort using the hands
  • Pain that gets worse when using the wrist for forceful activity, such as lifting objects or opening jars

Who to See and Types of Treatments Available

If you experience elbow pain or soreness that makes it hard to move your arm or do your regular activities, it is best to have it checked by your primary care physician. Your doctor will ask you to describe the pain that you are experiencing; this is often the primary method for diagnosing tennis elbow as it cannot be identified through an x-ray or a blood test.

In most cases, your family doctor will refer you to specialists who can provide proper treatment.

The type of treatment that your doctor will prescribe will depend on several unique factors, such as:

  • Your age
  • Overall health
  • Medical history
  • Intensity of pain
  • Medications being taken for other conditions/reasons

Treatment is only focused on:

  • Relieving pain and soreness
  • Reducing inflammation
  • Promote internal healing – A couple of weeks after the pain and inflammation settle down, it is time to begin the healing process so that the elbow can regain its normal strength. This is done by stretching and exercising the elbow muscles and tendons.
  • Decreasing further injury to the affected tendon

The available treatment options for tennis elbow include:

  • Physical therapy
  • Forearm bracing
  • Anti-inflammatory gels
  • Cortisone gels
  • Cortisone injections
  • Surgery - Surgery is rarely necessary and is often prescribed only in the most severe cases.

Home treatment is also possible; some of the things you can do to help your tennis elbow heal are:

  • Resting the entire arm to give the tendons time to heal; this may take weeks to months
  • Putting an ice pack on the affected area for 10 to 15 minutes, several times per day.
  • Taking hot baths to provide pain relief for the affected elbow
  • Keeping your elbow elevated as much as possible; this will help ease pain and inflammation

In order to promote faster healing of tennis elbow while treatment is ongoing, it is important to avoid certain activities that will cause strain or stress to the affected elbow. Gripping tightly and using the wrist too much should be avoided. You may find it necessary to use certain equipment while working in order to prevent further strain on your elbow. It helps to pay attention to the movements that cause pain so you can avoid them. Your doctor can also prescribe a counter-force brace, which is an elastic band that is wrapped around the injured elbow. It is effective in relieving pain.

There is a 90 to 95 percent chance of regaining your previous elbow strength with non-invasive treatment, even after suffering from tennis elbow. Only 5 percent of cases require surgery, and 80 to 90 percent of patients who undergo surgery for tennis elbow recover completely after the surgery. Other patients, however, need continuous physical therapy and will need to avoid forceful movements of the arm.

Medications for Treating Tennis Elbow

The following medications are usually prescribed for the treatment of tennis elbow:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen, and ibuprofen – These drugs, such as Bayer, Aleve, and Advil, provide pain relief but should be taken as instructed on the individual drug labels.

  • Acetaminophen – This is a different class of pain reliever; one example is Tylenol.

  • Corticosteroids – These can be administered topically or intravenously depending on the severity of pain. Their main purpose is to reduce inflammation and ease pain.
    References:

  • Orchard J., Kountouris A. (2011). “The management of tennis elbow.” British Medical Journal.

  • Robinson J., Hoens A., Scott A. (2013). “Treatment options for tennis elbow.” British Columbia Medical Journal.
  • Chesterton L., Mallen C., May E. (2011). “Management of tennis elbow.” Open Access Journal of Sports Medicine.
  • Bisset L., Beller E., Jull G. et al. (2006). “Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial.” British Medical Journal.
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