Also known as lateral epicondylitis, is characterized by pain on the outside of the forearm near the elbow that is made worse by such activities as lifting, bending or straightening of the elbow and gripping. It is the most common overuse injury of the elbow, 10 times more common than Golfer’s elbow which is similar but on the inside of the elbow.
It can be caused by overuse or knocking it. Overuse includes racquet or throwing sports, garden shears, paintbrush or roller usage, manual work and repetitive hand or wrist movements. Interestingly only a small number of tennis elbow cases are associated with playing tennis.
The pain is derived from inflammation and small tears where a forearm tendon joins the bone and the diagnosis is made by a skilled clinician with just a physical examination and not normally any need for x-rays or scans. The examination involves looking for tenderness and swelling plus special movements that cause the pain to come on, and that should distinguish it from other elbow conditions including nerve entrapment.
My approach to the treatment of Tennis Elbow
When the injury is fresh then treatment is aimed at settling the soreness down and preventing further aggravation. If the problem has persisted for a while then we aim to promote repair to the tendon and reverse chronic changes. Treatment may include manual therapy such as massage, manipulation, stretching and acupuncture. Correcting abnormal usage of the arm is important and bracing is sometimes recommended. A specific home exercise approach is usually included. There are a multitude of other approaches to the treatment of tennis elbow including topical gels, steroid injection, shock wave therapy, autologous blood injection and rarely surgery.
Tennis elbow can be self-limiting in many cases lasting weeks to months, however, some cases last for years.