Tennis elbow is a very common injury seen in people playing Tennis (specifically using the backhand stroke technique in the game) and so the name. A fact is that this condition also manifests in other people where tendons in the elbow are over-worked or injured due to repetitive motions of the wrist and arm. It is also known as Lateral Epicondylytis or Lateral Elbow Pain. The exact location of the pain is at the point where the tendons of the arm muscles meet the bony part on the outer side or lateral side of the elbow.
Severe pain can occur suddenly or within 72 hours at the elbow and can radiate towards the arm and wrist. You can have relief using common OTC (over-the-counter drugs) drugs for pain, cases in which the pain does not ease and causes disability, it is better to consult a doctor straightaway. Having adequate rest and cold-compress on the affected area are also benefit-table to an extent.
Cause
The possible cause could be due to the overuse of the arm muscle leading to a degenerative injury due to constant contraction. The injury can be in the form of minor tears with slight inflammation in the tendons and the presence of pain receptors in this area may increase the pain. The forearm muscles become painful due to tendon breakdown from over-stretching. Improper movement causes pressure to act on the tendon resulting in slight inflammation. In majority of the cases it is due to over-exertion of the muscles.
Symptoms
Pain is felt on the outer side of the arm – near the bony area, mainly when pressed at this site. The pain further radiates to the forearm. Weakness is felt at these places while trying to lift things. Stiffness and difficulty even while doing normal tasks and straightening fingers can be seen. The arm which is affected in majority of people is the dominant or over-used one and swelling also is seen in some cases.
Risk Factors
Risk factors increase your chance of getting a disease and such factors in the case of Tennis elbow are listed as under:
1. People who have more hand-movement in their work with repetitive motions of their arm and wrist are more prone.
2. People playing racket sports using improper techniques are more at risk when compared with others.
3. Tennis elbow is usually seen in people of the age-groups between 30 to 50 years.
4. Disorders such as calcification of the rotator cuff, carpal tunnel syndrome may increase the risk for developing Tennis elbow.
Diagnosis
Questions pertaining to medical history will be asked by your physician. Details about the symptoms, their duration, activity levels, nerve related problems if any, medication in use etc are asked to re-evaluate your condition.
An X-ray can be done to rule out other possibilities and to confirm that the pain occurring is due to Tennis Elbow only. Physical examination is done by applying some pressure and moving the elbow, wrist and fingers. Imaging techniques like MRI (Magnetic Resonance Imaging) can be advised so as to eliminate other causes leading to same pain in the elbow like neck pain, arthritis related, in order to confirm the diagnosis. Electromyography (EMG) is done to detect any problem with the nerves.
In most of the cases, X-ray, MRI results may be normal, but some abnormal changes in the tendons can be detected at times. Diagnosis is made from the results, physical examination, signs and symptoms.
Treatment
Symptoms can vary from person to person, so details about the pain; degree of disability, duration should be discussed with your doctor, prior to treatment. However, specific treatment options are not available; trials are ongoing for the same. The pain disappears in few cases on its own or after rest (best healing option) or simple treatment, but if the pain is causing disability then it needs prompt attention.
Some common pain relieving medicines (NSAID’s-Non-Steroidal-Anti-Inflammatory-Drugs) can be used and strengthening exercises (physiotherapy) under guidance can be practised for improvement in mobility. Amongst the more recent techniques – low level laser therapy, acupuncture, use of corticosteroids have shown considerable positive results to reduce pain on a temporary basis. However, in chronic cases, surgery remains as the only option when all other conservative treatments, rehabilitation programs have failed.
Lifestyle measures
Cold-compress, adequate rest, using elastic bandage to compress the affected area and by rising it a little to reduce swelling are some measures towards self-management of the condition. Maintaining proper posture, taking other ergonomic steps, doing some strengthening exercises under the guidance of a physiotherapist will go a long way in managing and preventing such problems in future.
An individualistic approach through a combination of treatments works best as each person reacts differently to a treatment option.
