Tennis Elbow Symptoms, Causes, and Treatments

A tennis elbow is a condition in which the swelling of the tendon causes pain

A tennis elbow, also known as lateral epicondylitis, is a condition in which the swelling of the tendon causes pain in the elbow or arm. Tendons are a band of tissues that connects the muscles of the lower arm to the bone. A tennis elbow is the most common cause of elbow pain. It commonly affects people aged 40 years. It usually requires minor treatment, time, and rest to heal.

Common signs and symptoms of a tennis elbow include pain or burning in the outer part of the elbow, weak grip strength, tenderness, and more.

The symptoms of a tennis elbow develop over time. In most cases, pain is mild, which then progresses to be severe over weeks and months. Common signs and symptoms of a tennis elbow include:

• Pain or burning in the outer part of the elbow
• Nocturnal pain
• Weak grip strength
• Tenderness

A tennis elbow develops gradually. Repetitive use of the muscles around the elbows is the main cause of developing a tennis elbow. Vigorous and repetitive use of the forearm muscle or repetitive stretching of the wrists and hands can lead to a tennis elbow. The extensor carpi radialis brevis (ERCB) muscle stabilizes the wrist when the elbow is straight. When ERCB is weakened from overuse, small tears form in the tendons leading to inflammation and pain.

Activities that may trigger a tennis elbow include:

• Tennis
• Squash
• Weightlifting
• Fencing
• Typing
• Raking
• Knitting
• Racquetball
• Painting
• Plumbing
• Carpentry
• Autoworkers
• Cooking
• Butchering

Other factors associated with a tennis elbow are as follows:

• Age between 30 and 50 years
• Idiopathic cause (unknown cause)

The physician may ask for patients’ detailed history, which would aid them in making a diagnosis. Moreover, the physician may ask for additional tests, which include:

• X-rays
• Magnetic resonance imaging (MRI) scan
• Electromyography (EMG)

Tennis elbow management involves both non-surgical and surgical methods. Approximately, 80-95% of patients have success with nonsurgical treatment.

• Resting your arm is of utmost importance because it heals inflammation and pain. Avoiding heavy activities and decreased participation in sports for some time can help in relieving painful symptoms.
• Using ice to foment the elbows immediately as the pain starts is a good way to stop swelling from increasing.
• Medications such as Tylenol (acetaminophen) and Motrin (ibuprofen) may ease swelling and pain.
• Steroids such as cortisone alleviate inflammation. The physician may inject steroids around the bony area to relieve painful symptoms.
• Specific exercises may help to strengthen the muscles of the forearms. Ice-massage or muscle-stimulating techniques may aid in improving muscle healing.
• Physicians may recommend the usage of a brace to relax the muscles and tendons, thus relieving the symptoms of a tennis elbow.
• Physicians may consider injecting platelet-rich plasma to improve the biological environment of the tissue. A small sample of blood is collected from the arm and centrifuged to obtain platelets from the solution. This therapy is still under consideration because there are studies that either defend or oppose the effectiveness of this therapy.
• Shock wave therapy sends sound waves to the elbows to create microtrauma that promotes the body’s natural healing process.

Physicians may recommend surgery if the symptoms do not respond to 6-12 months of nonsurgical treatment.

The surgical procedure mainly involves removing the diseased muscle and reattaching healthy muscle back to the bone.

There are two types of surgery performed to treat a tennis elbow:

• Open surgery: Done via a cut on the surface
• Arthroscopic surgery: Done via special tools and a camera. Its advantage is a smaller cut on the skin.