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Tennis Elbow

Tennis elbow, or lateral epicondylitis, is an injury that causes pain and inflammation in your elbow. It’s usually a repetitive strain injury linked to repeated motions of the wrist and arm.
Tennis Elbow

Causes of Tennis

ElbowTennis elbow is often attributed to overuse and muscle strain but the cause is not well understood. Repeated tensing of the forearm muscles that are used to straighten and raise the hand and wrist triggers the symptoms. This can cause a breakdown of the fibers in the tendon that attaches the forearm muscles to the bony bump at the outside of the elbow.

Activities that can cause tennis elbow symptoms include:

  • Playing racket sports, especially using backhand, with poor form.
  • Using plumbing tools.
  • Painting.
  • Driving screws.
  • Cutting up foods for cooking, particularly meat.
  • Using a computer mouse a lot.
  • Less often, an injury or a condition that affects the body’s connective tissues causes tennis elbow. 

In general, Athletes who play sports that put stress on their arms or elbows and People whose jobs or hobbies put lots of stress on their elbows are more likely to develop Tennis Elbow.

Symptoms of Tennis Elbow

Most people develop symptoms of tennis elbow in their dominant arm (the side you naturally use for most activities). You’re most likely to have a tennis elbow in whichever arm you use the most for a repetitive activity — the arm you hold a racket or tools with. Symptoms include: 

Elbow pain (especially on the outside of your elbow)

Elbow Stiffness. The muscles around the elbow can become tight or shortened due to pain and disuse.

Elbow Swelling. Swelling from conditions like tennis elbow can restrict movement.

A weakened grip (especially when you’re trying to hold something like a racket, pen or shake someone’s hand).

Symptoms exacerbated by activities that strain the forearm, such as lifting, gripping, or twisting movements.

Prognosis of Tennis Elbow

Tennis Elbow usually goes away with rest but can sometimes last over a year.  You should expect to take a break from the physical activities that caused tennis elbow. You may need to stop doing some activities completely, or do them with modifications (like wearing a brace while you work or taking breaks more often).

Diagnosis of Tennis Elbow

Your healthcare provider can often diagnose tennis elbow with a physical exam. In some cases, specific tests are utilized, such as:

X-ray: This is to look at the bones of your elbow. It is done to see if you have arthritis or other problems in your elbow.

MRI: This can show your tendons and the amount of damage. An MRI of your neck can show if arthritis is in your neck, or disk problems in your spine are causing your arm pain.

EMG (electromyography): This may show if you have any nerve problems in your elbow that may be causing your pain.

Pain Medicine Intervention of Tennis Elbow

Tennis Elbow can usually be treated with pain medicine intervention, activity modification and conservative treatment options. These include: 

  • RICE Method: 
    • Rest: Take a break from the activity that caused tennis elbow. Try to avoid using your elbow while it heals.
    • Ice: Apply a cold compress or ice pack to your elbow for 15 to 20 minutes at a time, a few times a day. Wrap ice packs in a towel or thin cloth so they don’t touch your skin directly.
    • Compression: Wrap a compression bandage around your elbow. Your provider can show you how to safely apply the compression bandage.
    • Elevation: Keep your elbow above the level of your heart as often as you can.
  • Brace: Wrist and elbow braces will allow your tendon to rest so it can heal. Your provider will tell you which kind of brace you’ll need and how often to wear it.
  • Over-the-counter (OTC) pain relievers: Over-the-counter NSAIDs or acetaminophen reduce swelling and relieve pain. Talk to your provider before taking these medications for more than 10 days in a row.
  • Corticosteroids: Corticosteroids are prescription anti-inflammatory medications. Your provider may inject cortisone shots into your injured elbow
  • Tenotomy: Your provider will poke a needle through your skin and into your injured tendon using an ultrasound to guide them. 
  • Shock wave therapy. Your provider will direct a specific pressure frequency where your tendon is injured.  This can help break up scar tissue, increase blood flow, and promote healing.

Treatment of Tennis Elbow

Tennis elbow can be treated with rest and medicines to help with the inflammation. Exercises often help too. In rare cases, surgery may be done to fix the tendon. If symptoms persist or worsen with conservative treatment, then other procedures may be recommended. 

  • Platelet-rich plasma (PRP). This treatment injects your own blood platelets into the affected area to promote healing
  • Tennis Elbow Surgery: Surgery to repair tennis elbow is often an outpatient surgery. This means you will not stay in the hospital overnight. The procedure is either an open surgery or performed using an arthroscope and the surgeon scrapes away the unhealthy part of the tendon. Surgery may be the best option if you are having pain that limits your activity and have tried other treatments for at least 3 months.

Procedure Videos

Elbow Injection

References

  1. Lateral epicondylitis (tennis elbow). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/lateral-epicondylitis-tennis-elbow. Accessed June 27, 2024.
  2. Schreiber, Armin M. “Tennis Elbow.” Schreiber MD, https://www.schreibermd.com/tennis-elbow. Accessed 27 June 2024.
  3. Tennis elbow. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/tennis-elbow/symptoms-causes/syc-20351987. Published November 4, 2022. Accessed June 27, 2024.
  4. Tennis elbow. MedlinePlus. https://medlineplus.gov/ency/article/007590.htm. Updated March 10, 2023. Accessed June 27, 2024.
  5. Tennis elbow (lateral epicondylitis). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/7049-tennis-elbow-lateral-epicondylitis. Accessed June 27, 2024.
  6. Tennis elbow (lateral epicondylitis). OrthoInfo – American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases–conditions/tennis-elbow-lateral-epicondylitis/. Published September 2021. Accessed June 27, 2024
  7. “Tennis Elbow.” NHS, https://www.nhs.uk/conditions/tennis-elbow/#:~:text=It%20usually%20goes%20away%20with,that%20can%20help%20if%20needed. Accessed 27 June 2024.