Lateral epicondylitis, epitrochlear bursitis are the other names for tennis elbow. This medical condition causes a soreness, inflammation or pain of the upper arm on the lateral (outer) side. The pain is located near the elbow. Sometimes tennis elbow pain could be due to the tendon fibers suffering a partial tear. Tendon fibers connect bone to muscle. The tear can be near or at the origin of the fibers.
Who are at Risk?
Tennis elbow symptoms are usually suffered by people who use these particular muscles repeatedly. Since, it is common to those who play racquet sports like tennis the name ‘tennis elbow’ has been given for this condition. Repeated use of these muscles causes small ruptures of the tendon.
Certain actions that cause tennis elbow symptoms are: the frequent use of the tennis backhand stroke using poor motion and technique; usage of plumbing tools; driving screws repeatedly by mechanics or carpenters; cooks who do a lot of cutting of ingredients like meat and use of the computer mouse and keyboard for long hours. Other jobs that use repeated motions of the arms and elbows and therefore make people susceptible are painters, butchers and construction workers.
Age is another risk factor where adults (30 – 50 years) are more susceptible to tennis elbow.
Symptoms of Tennis Elbow
Identifying tennis elbow symptoms and early treatment can cure you completely.
Elbow pain: This is the main symptom and the severity varies among patients. The patient feels tenderness and pain on the outer side of the elbow, traveling down the forearm, and towards the wrist. The pain is intensified when you bend the elbow, lift the arm or perform twisting movements etc. If the symptoms are not treated at once, it can worsen, causing radiating pain.
Repetitive wrist movements such as gripping and wrist extension can worsen the pain. The patient develops a weak grasp for he or she experiences pain even when gripping small objects, such as a holding a pen, a knife or a tool.
Motions like opening a bottle, holding a cup or glass or turning a door handle causes pain.
The patient is not able to fully extend the arm. Pain from tennis elbow symptoms may last anywhere between 6 months to a year. Sometimes the pain can be so strong that you may experience it even when resting or sleeping. As tendon damage increases, the pain gets worse and usage of the arm reduces. The body tries to compensate for the pain in the elbow by over using corresponding muscles, therefore resulting in pain of the rest of the affected arm, neck or shoulder.
What to do?
If the symptoms are mild, then home treatment like ice or over-the-counter NSAIDs can help. If the tennis elbow symptoms persist, then fix an appointment with your doctor.
Treatment of tennis elbow
Tennis elbow symptoms should be treated promptly for it can cause chronic pain and worsen the problem if untreated.
Description of your pain and the nature of your job or sports you play are sufficient for the doctor to identify tennis elbow. If the tendon damage is severe, the doctor could recommend an MRI or ultrasound scan to be done.
Physiotherapy, topical gels, cortisone injections, brace to protect the forearm is some of the treatments to cure tennis elbow. Surgery is usually not required. The line of treatment will depend on the patient’s medical history, age, severity of pain and overall health. The aim of the treatment is to reduce inflammation and pain, promote healing and help the patient use the arm normally.
The doctor will recommend you put ice on the affected area at least 2-3 times daily and avoid all activities that cause pain for sometime. NSAID’s help reduce pain and inflammation. Compression bandage on the injured area and elevation of the affected arm above the heart level can also reduce the amount of swelling. If tennis or some other racquet sport is the cause, you will be told to cut back, change technique or check if a change in equipment will help ease the pain.
Once the pain subsides, further treatment involving extensor muscle stretches, modification of activity and resistive exercises will be recommended. It is important to use the elbow in such a way to avoid further injury.
If surgery is required, it will be done to remove degenerative and scar tissue from the extensor tendons on the affected elbow. Most doctors will consider surgery only after 6-12 months of conservative, non-surgical treatment.
Sometimes neither conservative treatment nor surgery will improve the condition and cause complications. This could be due to nerve entrapment, overusing the arm that causes the symptoms to return and excessive use of steroid injections that result in tendons rupturing.
Tennis elbow : Prevention and Precaution
With prompt treatment, patients with tennis elbow symptoms (at least 90%) can completely recover within a year. The rest of the people who do not get better with conservative treatment will require surgery.
Tennis elbow maybe difficult to prevent due to the nature of the job or sport the patient takes part in. There are several precautionary measures that can be adopted reduce the risk of contracting tennis elbow symptoms again.
Stop the activities that cause pain. You can find alternate techniques to perform the task that does not affect the tendons. Use your wrist, elbow more often, and spread the load to the larger muscles in the upper arm and shoulder. If you play racquet sports and wish to continue playing, get the advice of your sports doctor. They may provide alternate techniques that reduce stress on the elbow. Do warm-up exercises before any sport that requires repetitive arm movements. Lightweight racquets and tools reduce the stress and strain on the tendons. A tennis elbow splint can help reduce the stress on the arm. This can be taken off when resting. Suitable exercises to strengthen these muscles can prevent the injury from recurring.
Managing your daily activities sensibly can prevent recurrence of this medical condition.