Tennis Elbow

Tennis elbow is a term used to describe pain in the tendons of the elbow brought on by overuse. It is sometimes called lateral epicondylitis. When your tendons are used over and over, they can tear. These small tears add up over time, creating pain in the place where the tendons meet the bone at the elbow joint. Pain can also spread through your forearm and to your wrist and can make it difficult to hold an item or shake hands.

Lateral epicondylitis [eh-pee-KON-dee-LYE-tiss], often called tennis elbow, happens when the tendons on the outside of the upper forearm are hurt from overuse. Tendons are a tough band of tissue that connect muscle to bone.

The upper arm bone (humerus [HYOO-mer-uss]) has bumps at the elbow. One of these bumps is called an epicondyle [ep-ih-KAHN-del]. The forearm has two bones, the radius and the ulna. Along with the humerus, these bones form the elbow joint. Muscles, ligaments, and tendons hold the bones in place and are responsible for movement at the elbow.

Repetitive movements (such as playing tennis or painting) can cause wear on the tendons. Over time, they can tear. These small tears add up and eventually cause pain in the place where the tendons meet the bone. Sometimes the pain is sudden. Most of the time, it starts as mild irritation and gets worse. The pain can also spread through your forearm to your wrist, making it difficult to do simple tasks, such as hold an item or shake hands.

Anyone who twists their wrist over and over, especially if that twisting requires strength, is at risk for tennis elbow.

It usually affects people between the ages of 35 and 54. Athletes, painters, plumbers, mechanics, and people who use a computer mouse for long periods of time are more likely to get tennis elbow.

The symptoms of tennis elbow include pain on the outside of your elbow, forearm, and sometimes, the wrist.

The pain is often mild at the start. It can get worse, especially without treatment. Usually, there is no specific injury linked to the start of your tennis elbow.

Tennis elbow may make it hard to grasp or hold things. Everyday actions such as shaking hands or turning a knob may be hard to do.

If you have not had these symptoms before or if your pain is sudden and severe, see your doctor.

You might also try self-care at home:

• Rest the arm for several days, or even weeks. Avoid any activity that aggravates the injury.
• Place an ice pack wrapped in a towel on the affected area every 15 to 20 minutes over 3 to 4 days to reduce swelling and pain
• Take over-the-counter pain relievers, such as ibuprofen, aspirin, or naproxen

If self-care does not relieve your symptoms, call your doctor.

Tennis elbow is caused by overuse of the tendons of the upper forearm. Playing tennis is one way to get tennis elbow, but many people with this condition have jobs or hobbies that require using the forearm in a repetitive way.

To find out what’s causing your pain, a doctor will examine your arm and ask questions about your pain and symptoms. The doctor will check to see if you have pain in your elbow when your wrist is bent back or if some motions make the pain better or worse.

To rule out other causes, imaging tests may be recommended.

• X-rays may be needed to rule out arthritis or a broken bone
• An MRI (magnetic resonance imaging) scan may be needed to look for a neck problem such as a herniated disk
• An EMG (electromyography [ee-LECK-tro-my-AH-graf-ee]) test may be needed to rule out nerve compression.

Self-care

The first thing to do is stop any sports or other activities that cause your elbow and arm pain. You can treat your tennis elbow at home using the RICE method. RICE stands for:

• Rest. Avoid putting weight on the injured elbow, and avoid participating in normal activities until your arm feels better.
• Ice. Use an ice pack (you can also use a bag of frozen vegetables if you do not have an ice pack) for 15-20 minutes, 3 to 4 times a day to reduce pain and inflammation in the tendon.
• Compression. A compression bandage or compression brace can be used to support the elbow and reduce swelling.
• Elevation. To keep swelling down, elevate (raise) your elbow above the level of your heart. You can do this by sitting or lying down on a couch or floor and placing pillows under your arm and elbow until your elbow is higher than your chest.

Consider changing the way you do whichever activity is causing your tennis elbow so that it doesn’t hurt your arm. At work, this might mean changing your chair, desk, or computer setup.

For sports, you could play less often or change the equipment you use. Ask your doctor for specific ideas or a referral to a sports medicine specialist.

Physical therapy

A physical therapist will teach your how to stretch your arm and build muscle that will ease the strain on your elbow.

Non-surgical procedures

Injections of cortisone [CORE-teh-zone] and a numbing medicine may be recommended to ease your pain and inflammation.

Surgery

Surgery might be recommended if other treatments do not relieve the injury.

To prevent tennis elbow, stretch your forearm muscles before doing any activity that can cause tennis elbow. You should also exercise the forearm and the muscles around it to keep it strong. Strong arm, shoulder, and upper back muscles can take some of the strain off your elbow.

You can also try these things:

• Have your sports equipment checked for a good fit
• Be sure to use proper form when playing sports
• Do not overuse your forearm
• Rest your arm after using a repetitive twisting motion
• Wear a counterforce brace if you are at high risk

MedlinePlus: https://medlineplus.gov/ency/article/000449.htm and https://medlineplus.gov/ency/article/007590.htm

American Academy of Orthopaedic Surgeons: http://orthoinfo.aaos.org/PDFs/A00068.pdf