Many of us may have heard of “tennis elbow” but what exactly is it
Lateral epicondylitis, commonly known as “tennis elbow”, is usually due to tendon inflammation of the muscles of the forearm where they attach to the outer elbow joint.
Lateral tennis elbow is most commonly an idiopathic or work-related condition. Even though the name of this injury may have the word “tennis” in it, fewer than 5% to 10 % of patients are tennis players. Occasionally a patient will present after sustaining direct trauma to the lateral elbow.
Many patients will describe a sudden acute onset of pain, such as that induced by lifting or from a blow striking the outside of the elbow. When patients are asked to indicate where the pain may be situated, most patients will point to the lateral epicondyle and often a vague, poorly defined area just distal to it.
It is important for the examiner to ask about the ability to grasp, carry and hold objects with the elbow extended and the ability to pick up objects or hold objects with the forearm in pronation and the wrist in palmar flexor. Many patients may also mention difficulty with shaving or even picking up a coffee mug.
When encountered with a patient presenting with any form of injury, taking their history is a vital step. In the case of tennis elbow, if a patient presents with electric or radicular sensory symptoms it may infer a neurologic cause. Clicking, locking or a feeling of elbow instability suggests a mechanical point imbalance. Patients with lateral tennis elbow reveal local tenderness a finger-breadth anterior and distal to the lateral epicondyle. Common symptoms of tennis elbow include tenderness on the outside of the elbow as well as morning stiffness of the elbow with persistent aching.
The next most common cause of lateral elbow pain is radial tunnel syndrome which is the compression of the posterior interosseous nerve in the region of the radial tunnel. Physical examination will reveal tenderness over the radial tunnel well distal to the lateral epicondyle, pain on resisted extension of the middle finger with pain located in the radial tunnel region, rather than the lateral epicondyle, and pain on resisted supination of the forearm.
There are many ways to treat tennis elbow but the most crucial step is to rest the tendon so that the small tears in the tendon can heal. As soon as you notice pain, apply cold packs for 10-15 mins at a time. Make sure that there is a cloth between the ice and your skin. You can also take nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammation.
Stretches, as well as cross friction massage, may help alleviate the pain. The final form of treatment is surgery, but this should be the last resort.
For more information on how to treat tennis elbow follow the link below.
Simple exercise to stop tennis elbow and golfer’s elbow. (Dougherty, 2017)
Akermark C, Crone H, Elsasser U, et al. Glycosaminologycanpolysulfate injections in lateral humeral epicondylagia:a place controlled double blind trial. Int J Sports Med 1995;16;196;200.
Calvert PT, Macpherson IS, Allum RL, Bentley G. Simple lateral release in treatment of tennis elbow. J R Soc Med 1985;78:912-5.
Dougherty, D. J. (2017, february). youtube. Retrieved from Simple exercise to stop tennis elbow and golfer’s elbow: https://www.youtube.com/watch?v=UCYbShdTtbk
Gardner RC. Tennis elbow: diagnosis, pathology and treatment: nine severe cases treated by a new reconstructive operation. Clin Orthop 1970;72;248-53.
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