Tennis Elbow

Tennis Elbow

Alternate Names

  • lateral epicondylitis
  • elbow tendonitis or tendinosis
  • Elbow

Definition

Tennis elbow is the name for a certain pain on the outside of the elbow. The pain occurs at the bony lump on the outside of the elbow, just above the joint. People who have never played tennis may develop this condition.

What is going on in the body?

Sudden or repeated stress can cause tiny tears in certain muscles and ligaments at the point where they attach to the outside part of the elbow. These are the muscles that straighten the wrist and fingers when they are bent. These muscles also rotate the forearm so that the palm faces up. Tennis elbow causes pain when these muscles are used, or when the outside area of the elbow is bumped.

Risks

What are the causes and risks of the condition?

Tennis elbow can be caused by a sudden tension on the muscle or ligament where it attaches to the outside of the elbow. Often this happens during a backhand stroke in racket sports, especially if the stroke technique is poor.
A much more common cause is chronic overuse of the muscles in a repetitive way. Examples of this are prolonged use of a screwdriver or typing, as well as playing sports like tennis.

Prevention

What can be done to prevent the condition?

Tennis players can avoid tennis elbow by improving their backhand stroke technique. Stretching before a game and exercises to strengthen the muscles can help prevent injuries. Computer workstations should be set up so that the wrists and fingers are well supported while typing.

Diagnosed

How is the condition diagnosed?

The history and physical examination are often enough for a healthcare professional to make the diagnosis. People often mention an activity that strains the involved muscles, such as tennis. The outside of the elbow is tender, and straightening the wrist or fingers against resistance causes pain.
X-rays are usually normal. However, these may be ordered in some cases to make sure nothing more serious is present.

Long Term Effects

What are the long-term effects of the condition?

Long-term effects are related to pain and difficulty in straightening the wrist. This may reduce the ability of people to play tennis or engage in other activities.

Treatments

What are the treatments for the condition?

Tennis elbow often goes away when the activity that caused it is stopped. It may help to lessen the frequency or intensity of the activity. Taking periodic breaks in the action may also help.
Resting the elbow and using ice on it can speed recovery. Physical therapy consists of stretching and strengthening the muscles that straighten the wrist and fingers. Non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen (i.e., Anaprox, Aleve, Naprosyn) or ibuprofen (i.e., Advil, Motrin) may be given for pain.
Injections of cortisone may also be used to relieve the pain. A tennis elbow band may be advised. This can be worn around the upper forearm to help stop the muscle forces from being carried up to the elbow.
Rarely, an operation on the elbow is needed when other treatments do not work.

Side Effects

What are the side effects of the treatments?

NSAIDs, especially if taken for a long time, can affect the stomach, kidneys, blood or liver. Cortisone injections carry a very small risk of causing infection. Cortisone injections may also weaken the tissues if used too often or cause the skin over the elbow to become pink, shiny, and thin.
If surgery is performed, there is a risk of bleeding, infection, and damage to the nearby tissues. For example, nerve damage may rarely occur. This could cause numbness in part of the arm.

After Treatment

What happens after treatment for the condition?

People are usually advised to slowly increase activities. Many people have a full recovery and can return to their normal activities. Regular strengthening or stretching exercises may help prevent tennis elbow from returning. Reducing the intensity of the activity that caused the injury may be advised.

Monitor

How is the condition monitored?

Tennis elbow is monitored by the affected person, who can notice the comfort level during physical activity.

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