Tennis Elbow is a painful condition that is not always related to swinging a racquet. Those who have not experienced it may not realize how serious it can be, making jokes about what caused the injury to occur. While Tennis Elbow may show up as the punchline, there is nothing funny about this painful condition. Tennis elbow can be debilitating, affecting everyday life in ways both major and minor. There are a number of ways to diagnose and treat this type of injury, helping you get back in the game.

What it is

The elbow is a joint constructed of three bones: the humerus in the upper arm and the radius and ulna in the lower arm. The humerus has two bony protrusions known as epicondyle. These epicondyle come together with connective tissue and ligaments and the bones of the lower arm to form the joint.

Each part of bone that connects is covered with cartilage that helps the bones move fluidly. In addition to this cartilage, the elbow is also lubricated by synovial fluid that helps movement as well. The entire joint is stabilized with connective tissue and cartilage.

Tennis elbow occurs when the epicondyle on the outside of the elbow joint becomes torn or inflamed. This can be as a result of repetitive motion causing wear and tear on the joint, or it can be caused by improper use of the joint.

A related condition, golfer’s elbow, is generally diagnosed as such because the pain occurs in the epicondyle on the inside of the elbow.

Symptoms of tennis elbow 

Tennis elbow has a number of different symptoms that can range from mild to severe. They include:

• Pain in the joint
• Swelling and redness
• Radiating pain, either up or down the arm
• Weakness in the joint or arm
• Stiffness in the morning
• Numbness or tingling in the arm, elbow, or fingers

People with tennis elbow sometimes report difficulty making a fist. This affects everyday activities, including opening doors, lifting objects, or shaking hands.

Risk factors

Tennis elbow is most common in athletes who are repeatedly taxing the elbow joint. Although this injury can have a sudden onset, it is most commonly diagnosed as a repetitive motion injury. Over time, even casual players can develop this injury.

But this injury is not restricted to athletes, either professional or amateur. Occupations that strain the muscles of the forearm – plumbing, painting, and carpentry – also experience high rate of tennis elbow.

Diagnosis

The most common diagnostic tool for tennis elbow is an in-depth patient interview that looks at types of activities and onset of pain. Other diagnostic tools include a physical examination of the area to find any tender spots. MRIs and X-rays may be ordered to rule out other potential diagnoses, but they are not required to make a diagnosis of tennis elbow.

Treatments for tennis elbow

The first line treatment of tennis elbow is truly prevention. Utilizing proper form in all activities can help prevent this condition.

Once a diagnosis of tennis elbow is made, there are a number of treatment options.

• Rest: For mild cases of tennis elbow, rest may be all that is needed. This can include minor, supported stretching of the joint but generally avoids any strenuous activity.
• Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDS): Over-the-counter non-steroidal anti-inflammatory drugs are usually diagnosed in conjunction with periods of rest. Because excessive use of NSAIDS over a long period of time can have severe gastrointestinal side effects, it is important to work closely with your doctor to monitor whether or not these drugs are helping.
• Physical therapy: As the injury progresses in severity, physical therapy may be necessary to safely and properly exercise and strengthen the muscles surrounding the joint to provide better support and stability.
• Supportive braces: Braces can be used while in recovery and then also during more strenuous activity. This is often recommended for those who have just recovered from tennis elbow as a preventative measure against re-injury.
• Injections: For tennis elbow that does not respond to less-invasive treatments, injections at the injury site may provide relief from pain and reduction in inflammation. These injections generally utilize a steroid to minimize inflammation as well as an analgesic such as lidocaine for pain relief. While these types of injections are considered minimally-invasive, they are best reserved for refractory pain that does not respond to other treatments.
• Surgery: In the most severe cases of tennis elbow, surgery to remove the affected muscle tissue may be the only treatment option that provides relief.

There is some evidence that acupuncture can offer relief for joint pain. Many who experience persistent or refractory pain due to tennis elbow would be well-advised to give this complementary therapy a try in conjunction with more traditional treatments. Many pain doctors are beginning to work with qualified acupuncturists to address tennis elbow in a more holistic manner. Because of this, many insurance companies now provide some level of coverage for a number of acupuncture sessions.

Side effects to treatment

The risk of side effects for the treatment of tennis elbow are generally minimal, even in the case of injections and surgery. Injection-related side effects may include redness and soreness at the injection site. Surgical risks include infection, tissue damage, and loss of strength or range of motion in the elbow joint.

As stated above, the side effects of acupuncture are minimal or non-existent.

Tennis elbow can impact the quality of daily life unless properly diagnosed and treated. What treatments have you tried for tennis elbow, and what was the result?

Photo by Basheer Tome via Flickr

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