Tennis elbow

Tennis elbow

Tennis elbow (also called lateral epicondylitis) is an overuse injury resulting in pain around the outside of the elbow joint.

Tennis elbow is relatively common (although severity varies significantly) and affects around 30% of people (most common in people aged 40 to 60). It is more prevalent to occur in one’s dominant arm but can occur on the other arm or both arms.

Symptoms include the following:

• The pain associated with tennis elbow is usually a gradual increase of pain around the lateral (outside) aspect of the elbow joint. Seldom, there could be a sudden onset of pain.
• The pain felt is worse when squeezing objects or shaking hands.
• The pain is exasperated when stabilising or even moving the wrist with force. Eg. Using tools or opening jars.

Despite its name, tennis elbow is not limited to tennis players. It can affect any sport or activity that requires constant gripping and repetitive wrist, elbow and arm movements. Sedentary activities such as playing with game consoles or using a computer mouse have also been known to elicit tennis elbow injuries.

Diagnosis of tennis elbow is usually achieved by a physical examination from a medical practitioner as symptoms and location of pain is usually enough to provide a diagnosis (there are many possible injuries affecting the elbow joint so one always need to consult a professional to ensure a correct diagnosis). Sometimes, the practitioner may require further investigations, such as X-rays or MRI’s to rule out any other more sinister problems.

Treatment of tennis elbow is usually successful with conservative methods with the main goals being to eliminate pain and inflammation; promote healing of the involved tissues; decrease load and stress placed on the affected elbow; and to facilitate a return to full range of motion of the arm.

The treatment protocol can include all/some of the following:

• Rest: Tennis elbow should usually heal on its own if you just give it sufficient time to recover and don’t stress it.
• Ice: Icing the area with speed up the inflammatory response and thereby reducing the pain and swelling more quickly.
• Elbow guards/straps: These have been used to help offload the ‘stressed’ tendon thereby facilitating recovery.
• Range of motion exercises: These can be done at home a few times a day to help reduce the associated stiffness of the joint (with inactivity) and assist in increasing the flexibility of the arm.
• Physiotherapy: This is essential in strengthening and lengthening the correct muscles to help create a long-term solution to offloading the tendon.
• Medical intervention: Painkillers and NSAID’s can help manage the pain and assist in reducing the inflammation. Steroid injections could also be administered to assist in the swelling and pain. Note that no medication should be taken without a GP’s consent or approval as side-effects are evident and need to be discussed with the patient.
• Alternative intervention: Shock wave therapy and dry needling have been known to reduce pain and speed up recovery.

As mentioned earlier, conservative treatment should work but in the case of the pain not subsiding within a few months, surgery may be an option. Surgery involves releasing the damaged tendon and repairing the remaining healthy tendon and has been known to be successful in about 80%-90% of operations.