Tennis elbow (lateral epicondylitis) is a condition characterized by swelling of the tendons that bend your wrist backward away from your palm. It involves inflammation or small tears in the tendons that attach the forearm muscles to the bony bump on the outside of the elbow (lateral epicondyle).

Common Symptoms

• Pain or burning sensation on the outside of the elbow that may radiate down the forearm
• Weakness or difficulty gripping objects
• Pain when shaking hands, turning a doorknob, or lifting objects

Cause & Anatomy

Tennis elbow is caused by overuse or repetitive stress on the forearm muscles and tendons that attach to the lateral epicondyle. This can occur from activities like:

• Playing tennis or other racquet sports with improper technique
• Repeated motions of the wrist and arm in jobs like plumbing, painting, carpentry, etc.
• Using tools that require a strong grip like screwdrivers, hammers, etc.

The key anatomical structure involved is the extensor carpi radialis brevis tendon, which attaches the forearm muscle to the lateral epicondyle of the humerus bone. Inflammation or microtears in this tendon cause the symptoms.

Diagnosis

Tennis elbow is usually diagnosed based on:

• Physical examination to check for point tenderness on the lateral epicondyle
• Assessing pain with resisted wrist extension
• X-rays or MRI may be done to rule out other conditions like arthritis

Prevention

• Proper technique and equipment for racquet sports
• Taking breaks from repetitive wrist/arm activities
• Keeping elbows slightly bent when exercising or lifting
• Strengthening forearm muscles through exercises

Treatment

• Rest and activity modification to avoid aggravating movements
• Ice packs to reduce inflammation
• Over-the-counter anti-inflammatory medications like ibuprofen
• Stretching and strengthening exercises
• Braces or straps to reduce stress on the tendon
• Steroid injections for severe cases
• Shock wave therapy or platelet-rich plasma injections

Surgery

Surgery is occasionally needed but may be considered if non-surgical treatments fail after 6-12 months. It involves removing the damaged tendon and reattaching healthy muscle and tendon to the bone.

Rehabilitation

Rehabilitation focuses on restoring range of motion, strength, and function through:

• Gentle stretching and range-of-motion exercises
• Gradual strengthening of the forearm muscles
• Activity modification to avoid re-injury

FAQ’s

Is tennis elbow only caused by playing tennis?
No, despite the name, tennis elbow can occur from any repetitive wrist/arm activity, not just tennis.

How long does it take for tennis elbow to heal?
Recovery can be slow, taking 6-12 months with conservative treatment like rest and exercise.

Can tennis elbow go away on its own?
Yes, tennis elbow often resolves with time and avoiding the aggravating activity, though it may take several months.

Is surgery always needed for tennis elbow?
No, surgery is the last resort if non-surgical treatments fail to provide relief after an extended period