What is tennis elbow?

Tennis elbow is an injury that causes pain and inflammation in your elbow. It is usually a repetitive strain injury.

Repetitive strain injuries occur when you use part of your body to repetitively do the same kind of motion so frequently that it damages your tissue.

Tennis elbow is the colloquialism provided for this type of sports-related injury that those who participate in racket sports, particularly tennis, develop due to repetitive overuse of the tendon that connects the muscles in your forearm with your elbow.

The medical term for tennis elbow is lateral epicondylitis. Epicondylitis is inflammation of the extensor muscle tendon, and lateral epicondylitis means the inflammation is on the outside or the lateral side.

Any activity in which you must grip or twist and swing your forearm often can cause tennis elbow. See a healthcare provider if you have an elbow injury or pain that does not go away in a week. The sooner you see a provider when you first notice the pain, the more treatment options you will have (and the better they may work).

What are the symptoms of tennis elbow?

The most common tennis elbow symptoms include:

• Elbow pain, particularly on the lateral side of your elbow- that's the farthest side from your body's midline when arms are at your sides, with palms facing front.
• Stiffness in your elbow and forearm.
• Swelling in front of the elbow.
• A weak grip, especially when trying to clasp onto something, such as a racket, pen, or someone's hand.

How do you determine whether you have a tennis elbow?

You can only be sure you have a tennis elbow once you see a medical provider to determine what is causing your pain. Many people with tennis elbow describe a distinctive type of elbow pain and arm pain. Pain: Although this generally is the most consistent feature, it varies from person to person, the pain typically is: Sharp or burning. Worse with twisting or bending motions (when you turn a doorknob, open a jar or swing your arm).

Unlike it radiates from your elbow down to your forearm and into your wrist, particularly at night.

Is tennis elbow bilateral or unilateral?

Most people get their tennis elbow in the dominant arm or the one they use most often. You are most likely to get tennis elbow in the arm you use the most for an activity you repeat — the arm you hold a racket or tools with.

It isn't common, but technically you can get both arms of your tennis elbow simultaneously.

What causes tennis elbow?

Any activity or movement you consistently do can cause tennis elbow. Cumulative stress from repeated movements occurs over time. It leads to the time it causes small tears, or microtraumas, in that added use and stress on your extensor muscle tendon. Those microtraumas lead to symptoms that you can feel and notice.

It is less common, but a sudden arm or elbow injury can also cause tennis elbow.

What are the risks for tennis elbow?

Anyone can get tennis elbow, but certain people are more likely than others, such as those:

• Held regular activities lifting 45 or more pounds (22 kilograms).
• Are 40 years of age or older.
• Smoke .
• Have obesity, which means a BMI of 30 or greater.
• Athletes who engage in sports that tend to stress the arms, such as:
• Throwing activities like tennis or baseball.
• Tennis (as well as pickleball, squash, and racquetball, among other racket sports).
• Baseball.
• Softball.
• playing bowls.
• Play golf.
• lifting weights.

Jobs or hobbies that put lots of stress on your elbow, such as:

• Painters.
• Musicians.
• Chefs or cooks.
• Carpenters.
• Plumbers.
• Cleaners.
• Gardeners.
• Manicurists.

What are the complications of tennis elbow?

Tennis elbow generally does not lead to serious complications. If you continue using your injured elbow before your tendon has healed, you may increase your chance of rupturing (tearing) it.

How is tennis elbow diagnosed?

Your healthcare provider diagnoses tennis elbow with a physical exam and some tests. They will examine your injured elbow and ask questions regarding your symptoms. Let your provider know when you first noticed pain, stiffness, or other symptoms and what activities make them worse (or better).

Tennis elbow tests:

Your doctor will probably need to perform several of the following tests to detect damage inside your arm as well as take pictures of your elbow:

• Elbow X-ray.
• Ultrasound.
• Magnetic resonance imaging (MRI).
• Electromyography (EMG).

What are the treatments for tennis elbow?

Your doctor will prescribe some treatments to heal your tendon. The RICE method is generally best to treat tennis elbow:

• Rest: Avoid the activity that caused you to develop tennis elbow. Try avoiding using your elbow as much as possible during healing.
• Ice: Apply ice to the affected area for 15 to 20 minutes several times a day. Wrap an ice pack or a towel with ice in it around the elbow. Do not place ice directly on the skin to avoid injury from the cold. Compression: You can apply a compression bandage over the elbow. Your provider will guide you through this safely.
• Lift: As much as possible, elevate your elbow high enough to be above your heart's level.

Other conservative nonsurgical treatment for tennis elbow:

• OTC Pain Medications: OTC NSAIDs or acetaminophen reduce swelling and pain. Make sure you get the approval of the doctor before you take these medicines for more than 10 consecutive days.
• Physical therapy: A physical therapist will show you stretches and exercises that can help strengthen the muscles around your elbow, allowing you to be more flexible.
• Bracing: Wrist and elbow braces allow your tendon to rest while healing. Your provider will prescribe the correct brace and tell you how long you should wear it every day.
• Platelet-rich plasma: Your doctor will take some of your blood and process it to increase the concentration of the proteins called platelets, which help in healing. He will inject that processed blood into your elbow.
• Corticosteroids: Corticosteroids are the kinds of prescription anti-inflammatory drugs. Your doctor may inject cortisone shots into your elbow. Corticosteroids are not used often because they don't have a positive response to your pain most of the time, especially when you have actually been feeling pain for more than six weeks.
• Tenotomy: Your doctor will apply an ultrasound that will guide a needle through your skin to your inflamed tendon. He or she will break up and remove damaged tissue, letting your body heal naturally.
• Shockwave therapy: Your doctor will apply a specific pressure frequency to the area where your tendon is injured. Shockwaves tell your body to heal faster.

What are the surgeries for Tennis elbow?

Most people don't need surgery for tennis elbow. If you have tried conservative treatments for several months and you still have severe symptoms, your physician may suggest that you receive surgery.

Your surgeon will remove the damaged tissue and repair the damaged areas of your tendon. Most tennis elbow surgeries are outpatient surgical procedures-this is a medical term to say that most patients can go home on the same day that they undergo the surgery.

Your surgeon will let you know how much surgery you'll need, what to expect, and how quickly you can expect to recover. 

How soon after I undergo treatment will I improve?

You should start to feel better within a few days after you begin avoiding the activity and resting your elbow. However, it can take several months for your elbow to heal. This will depend on what caused the injury, how significantly it damaged your tendon, and how long you have been experiencing pain. Talk to your provider about what you can expect.

How might I prevent tennis elbow?

Avoid overuse of the arm and elbow as a preventive measure to avoid tennis elbow.

• Wear proper protective gear for every type of work, sports, or leisure while taking part in sports or any other physically demanding activity.
• Don't try "playing through the pain" during or after exercise.
• Give your body some time to rest and recover after intense activity.
• Stretch and warm up before sports or a workout.
• Cool down and stretch after exercising.
• Engage in activities tailored to your sport or that maintain your physical fitness for your occupation, hobbies, or sports.

What should I expect if I have tennis elbow?

You can expect to avoid the activities that caused tennis elbow. You will either be forced to stop doing some things entirely or modify them (such as wearing a brace while you work or taking more frequent breaks).

The good news, however, is that almost every person fully recovers from tennis elbow. After the healing of the tendon, which may take some time, you can resume all your previous activities even if you had surgery.

How long does tennis elbow last?

Tennis elbow is a condition that lasts from a few months to over a year. On average, recovery takes six months, but some people may take longer, up to 18 months.

What will determine how long it'll take you to recover is a few things:

• What's causing the tennis elbow?
• How badly damaged your tendon is.
• Which treatments you require.

Living With

When should I see my healthcare provider?

You should visit a healthcare provider if you suspect your elbow is hurt or notice any of the following symptoms of tennis elbow:

• It hurts to move your elbow or arm.
• Your elbow is inflamed or discolored.
• You feel pain as extreme as it can cause you to stop or at least avoid doing what you had planned, even in sleep.
• You have been experiencing this type of pain for more than a week.

To seek an expert consultation for any orthopedic condition.

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