Tennis Elbow

Tennis elbow, or lateral epicondylitis, an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow. Any activity, including playing tennis, which involves the repetitive use of the

extensor muscles of the forearm can cause acute or chronic tendonitis of the tendinous insertion of these muscles at the lateral epicondyle of the elbow. The condition is common in carpenters and other laborers who swing a hammer or other tool with the forearm.

Causes

The site of the pain in tennis elbow is where some tendons from your forearm muscles attach to the bone around your elbow. The pain is thought to be due to an injury, or several tiny injuries, to one or more of these tendons. An injury can cause a tiny tear to a tendon and lead to inflammation and scarring of the tendon.

Injuries are usually caused by overuse of your forearm muscles in repeated actions such as wringing clothes or manual work (particularly with twisting movements such as using a screwdriver). Playing tennis or other racquet sports can also cause tendon injuries. However, despite being called tennis elbow, racquet sports are only thought to be the cause in about 5 in 100 cases. In most people, tennis elbow affects your dominant arm (the arm that you write with).

Symptoms

The pain associated with tennis elbow may radiate from the outside of your elbow into your forearm and wrist. Pain and weakness may make it difficult to:

• Shake hands
• Turn a doorknob
• Hold a coffee cup

Exams and Tests

Your doctor or nurse will examine you.  The exam may show:

• Pain or tenderness when the tendon is gently pressed near where it attaches to the upper arm bone, over the outside of the elbow.
• Pain near the elbow when the wrist is bent backwards.

X-rays may be done.

Treatment

However, there are treatments that can be used to improve your symptoms and speed up your recovery.

• It's important that you rest your injured arm and stop doing the activity that's causing the problem.
• Holding a cold compress, such as a bag of frozen peas wrapped in a towel, against your elbow for a few minutes several times a day can help ease the pain.
• Taking painkillers, such as paracetamol, may help reduce mild pain caused by tennis elbow. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also be used to help reduce inflammation.

Tennis elbow often gets better on its own. But if over-the-counter pain medications and other self-care measures aren't helping, your doctor may suggest physical therapy. Severe cases of tennis elbow may require surgery.

Therapy

Learn proper form. Your doctor may suggest that experts evaluate your tennis technique or the movements involved with your job tasks to determine the best steps to reduce stress on your injured tissue.

• Exercises. Your doctor or a physical therapist may suggest exercises to gradually stretch and strengthen your muscles, especially the muscles of your forearm.
• Braces. Your doctor may also suggest you wear a forearm strap or brace to reduce stress on the injured tissue.

Surgery

If your symptoms haven't improved after six to 12 months of extensive conservative therapy, you may be a candidate for surgery to remove damaged tissue. These types of procedures can be performed through a large incision or through several small incisions. Rehabilitation exercises are crucial to recovery.

Prevention

You often cannot avoid a sudden overuse of the arm, which can cause tennis elbow. However, if you increase the strength of your forearm muscles, it may help to prevent a further bout of tennis elbow in the future. The aim is to exercise and strengthen the muscles, but to avoid twisting movements. It is best to see a physiotherapist for advice on how to strengthen your forearm muscles.