TENNIS ELBOW

Tennis elbow, or lateral epicondylitis, is a painful condition resulting from inflammation of the tendons in the elbow. The main cause of tennis elbow is overuse of the wrist extensors (the muscles on the outside of the elbow that are responsible for some control of the wrist) and, less commonly, trauma. It is often associated with repeated movements of the wrist and hand, including lifting, gripping, or twisting.

Despite its name, most people who develop this condition are not athletes, but people in occupations that require repetitive motions, such as painters, carpenters, tradesmen, plumbers, doctors, artists, computer technicians, etc.

Tennis elbow pain occurs on the outside of the elbow, with a specific, very painful point when pressed. It can spread down the forearm to the fingers and up to the shoulder joint.

Symptoms

Lateral epicondylitis usually develops gradually. In the beginning, a slight discomfort is felt, such as muscle weakness, tension in the arm, and slowly over time the complaints intensify. The pain on the outside of the elbow also increases when the hand is overused, and in some cases it can spread to the forearm and lead to numbness and tingling in the fingers.

Tennis elbow is a progressive disease and if left untreated can lead to impaired function of the hand and difficulty in performing daily activities, such as:

• Lift and grip an objects (e.g. a coffee cup)
• Shake hands
• Turn a doorknob
• Brush teeth
• Clench a fist
• Stretch or twist the fingers

Tennis elbow usually affects the dominant hand, i.e. right-handed people tend to develop lateral epicondylitis in the right hand, and left-handed people in the left. However, both arms can be affected, with it estimated that up to 20% of patients develop bilateral tennis elbow.

Risk factors

• Age - affects people of all ages, but is most common in adults between 30 and 60
• Occupation - people whose work involves repetitive movements of the wrist and hand (chefs, butchers, fitters, doctors, manicurists, etc.) are more likely to develop tennis elbow
• Certain sports - tennis, baseball, bowling, badminton
• Other factors that can increase the risk of developing tennis elbow are: regular weight lifting, obesity, certain medications.

Diagnosis

Tennis elbow is usually diagnosed based on a medical history and physical examination. To confirm the diagnosis, your doctor may do an ultrasound, order an X-ray, electromyography (EMG) or magnetic resonance imaging (MRI).

Treatment

Treatment of tennis elbow depends mainly on the severity of the pain.

Conservative treatment

• Rest – limiting (if possible stopping) activities that provoke pain.
• Ice – can temporarily relieve elbow pain.
• Medicines - pain relievers and NSAIDs (non-steroidal anti-inflammatory drugs) to relieve pain and reduce swelling.
• Physiotherapy – specific exercises to strengthen the muscles of the forearm.
• Brace – When the disease is related to your work and it is difficult to stop or limit the activities that cause the pain, wearing a brace is appropriate. Braces apply pressure to the muscles below the elbow and reduce symptoms by providing rest to the muscles and tendons. This way, you will be able to perform daily activities with less discomfort. They can be worn throughout the day and removed at night. MediVaric Elbow Brace
• Steroid injections – used to control inflammation and relieve pain, but cannot be used long-term.
• PRP therapy (platelet-rich plasma) – injection of platelet-rich plasma into the affected area.

Surgical treatment

If symptoms have not improved after 6-12 months of conservative treatment, surgery may be necessary.