Tennis elbow, medically known as lateral epicondylitis, is a condition that develops due to repetitive strain on the forearm muscles and tendons, leading to pain and inflammation around the outer elbow. Despite its name, this condition is not limited to tennis players but can affect anyone engaging in repetitive wrist and arm movements.
The pain from tennis elbow is caused by small tears in the tendons that attach to the lateral epicondyle, a bony prominence on the outer part of the elbow. Over time, these microtears can lead to chronic degeneration of the tendon if left untreated. The condition develops gradually and can result in significant discomfort, particularly when gripping or lifting objects.
Tennis Elbow vs. Golfer’s Elbow
Tennis elbow and golfer’s elbow are similar conditions but affect different parts of the elbow:
- Tennis Elbow (Lateral Epicondylitis): Affects the tendons on the outer elbow, primarily impacting wrist extensor muscles.
- Golfer’s Elbow (Medial Epicondylitis): Affects the tendons on the inner elbow, primarily impacting wrist flexor muscles.
Both conditions arise from repetitive motion but affect different muscle groups, leading to distinct pain locations.
What Causes Tennis Elbow?
Tennis elbow results from repetitive strain on the forearm tendons, causing small tears that lead to pain and inflammation. Common causes include:
- Repetitive wrist and forearm movements: Actions that involve frequent gripping, twisting, or lifting can strain the tendons.
- Sports-related overuse: Racquet sports, weightlifting, and baseball are common culprits.
- Poor technique and equipment: Incorrect sports techniques or using improperly sized equipment can increase strain on the tendons.
- Work-related strain: Jobs requiring frequent wrist and forearm movements, such as carpentry or painting, elevate the risk.
Common Activities That Can Lead to Tennis Elbow
Tennis elbow can develop due to various repetitive movements, including:
Sports
- Tennis
- Badminton
- Squash
- Baseball
- Weightlifting
- Fencing
Occupational Tasks
- Carpentry
- Painting
- Plumbing
- Butchery
- Cooking (frequent chopping motions)
Repetitive Daily Movements
- Typing and computer work
- Sewing and knitting
- Playing musical instruments
- Gardening and heavy manual labor
Risk Factors
Several factors increase the likelihood of developing tennis elbow:
- Age: Most common in individuals between 30 and 50 years old.
- Occupational strain: Jobs requiring repetitive hand and arm movements increase the risk.
- Sports participation: Activities that place repeated stress on the forearm tendons contribute to the condition.
- Muscle weakness: Insufficient forearm strength can make tendons more vulnerable to strain.
Common Symptoms of Tennis Elbow
Tennis elbow symptoms usually develop gradually. Common signs include:
- Pain and tenderness on the outer elbow
- A burning sensation radiating down the forearm
- Weak grip strength
- Increased pain during gripping, lifting, or twisting motions
- Stiffness and reduced arm flexibility
Acute vs. Long-term Tennis Elbow Symptoms
Acute Symptoms
- Sudden pain after excessive arm activity
- Mild inflammation around the elbow
- Temporary weakness in the forearm
Chronic Symptoms
- Persistent, worsening pain over weeks or months
- Decreased grip strength affecting daily tasks
- Tendon degeneration due to prolonged overuse
When to See a Doctor
Signs That Require Medical Attention
- Persistent pain despite rest and self-care measures
- Reduced grip strength making daily tasks difficult
- Limited elbow movement due to stiffness
Urgent Situations Needing Immediate Care
- Severe swelling, redness, or warmth around the elbow
- Sudden loss of elbow movement
- Numbness or tingling in the fingers, suggesting nerve involvement
Importance of Early Diagnosis
Early diagnosis is crucial to prevent worsening symptoms. Ignoring prolonged pain may lead to chronic tendon damage, requiring more extensive treatment.
How is Tennis Elbow Diagnosed?
Your Doctor May Ask:
- When did the pain start?
- What activities aggravate the pain?
- Have you experienced previous elbow injuries?
Physical Examination
- Checking for tenderness around the lateral epicondyle
- Assessing grip strength and wrist movement
Specific Provocative Tests:
- Cozen’s Test: Resisted wrist extension to check for pain
- Mill’s Test: Stretching forearm muscles to assess discomfort
- Maudsley’s Test: Resisted middle finger extension test
Differential Diagnosis: Ruling Out Other Disorders
- Golfer’s elbow
- Arthritis
- Nerve compression syndromes
Treatment Options for Tennis Elbow
Non-Surgical Treatments
Non-surgical treatments are the preferred approach for managing tennis elbow. These treatments aim to reduce pain, improve mobility, and strengthen the affected tendons.
- Rest and Activity Modification
- Avoiding activities that aggravate the condition
- Using ergonomic adjustments at work
- Pain Management
- Over-the-counter NSAIDs like ibuprofen for inflammation relief
- Ice therapy to reduce swelling and discomfort
- Physical Therapy
- Stretching and strengthening exercises
- Soft tissue massage to improve circulation and healing
- Bracing and Support
- Counterforce braces to reduce strain on tendons
- Wrist splints to provide additional support
- Corticosteroid Injections
- Temporary relief by reducing inflammation
- Platelet-Rich Plasma (PRP) Therapy
- Using the patient’s own blood platelets to promote healing
Surgical Treatments
Surgery is recommended when conservative treatments fail. The goal is to remove damaged tissue and repair the affected tendon.
- Open Surgery
- A traditional approach involving an incision over the elbow
- The surgeon removes degenerated tendon tissue and may reattach healthy tissue
- Requires longer recovery time but is effective for severe cases
- Arthroscopic Surgery
- A minimally invasive procedure using small incisions and a camera-guided approach
- The damaged tendon tissue is cleaned out using specialized instruments
- Offers a shorter recovery period compared to open surgery
- Percutaneous Tenotomy
- A newer technique using ultrasound guidance to break up scar tissue
- Minimally invasive and reduces trauma to surrounding structures
- Often performed in an outpatient setting with quick recovery
- Tendon Release Surgery
- Involves cutting the affected tendon to release tension
- Used in severe cases where other procedures have failed
- Followed by physical therapy to restore strength and function
Post-Surgery Recovery
- Gradual return to daily activities over several weeks
- Physical therapy to restore flexibility and strength
- Avoiding heavy lifting and repetitive motion during healing
- Complete recovery may take several months, depending on individual healing rates
Alternative and Complementary Therapies
- Acupuncture for pain relief and muscle relaxation
- Shockwave therapy to promote healing and tendon repair
- Herbal anti-inflammatory treatments to reduce discomfort
Tennis elbow can be painful, but with the right treatment and preventive strategies, full recovery is achievable. Seeking early treatment and making lifestyle adjustments can significantly improve outcomes and prevent long-term complications.
Tennis elbow is a common overuse injury that can affect your daily routine, work performance, and sports activities. What begins as mild discomfort can progress into persistent pain and restricted arm movement if left untreated. However, with early intervention, appropriate treatment, and a structured rehabilitation plan, most individuals recover fully without requiring surgery.
If you’re experiencing ongoing elbow pain or suspect you may have tennis elbow, Dr. Vishal Sahni, a renowned shoulder specialist at London Orthopaedic Clinic, Dhantoli, Nagpur, offers expert diagnosis and treatment. Our dedicated team provides personalized care, advanced therapies, and tailored recovery plans to help you regain strength and mobility. Book a consultation today and take the first step toward a pain-free, active life.