Tennis Elbow, medically known as Lateral Epicondylitis, is caused by inflammation or sometimes micro-tears of the tendons that connect the outside of the elbow to the forearm muscles.
Many of the causes and symptoms of tennis elbow are similar to Golfers Elbow (Medial Epicondylitis), though the pain and discomfort from that condition presents on the inside part of the elbow as inner elbow pain that is sometimes associated with Pitcher’s Elbow.
People who play racquet sports, such as tennis, commonly experience this condition. Hence the name “tennis elbow,” but anyone that repeatedly grips an object, engaging their fingers and wrists, whether for work or sport, can develop pain and inflammation on the outside of the elbow.
What is Tennis Elbow and What Causes Lateral Epicondylitis?
Lateral Epicondylitis is a form of tendinitis that can be especially irritating and painful. It can cause diminished range of motion and without proper tennis elbow treatment, the symptoms will likely worsen and lead to unwanted downtime.
Though lateral epicondylitis can be caused by sudden trauma, tennis elbow causes are generally a matter of overuse. This condition usually develops over time and is the result of a repetitive grip or extension-related movements.
Overuse of the forearm muscles can irritate the tendons, which attach the muscles to the bone, leading to tenderness, swelling, stiffness and pain. Unfortunately, age can play a factor in this condition because of the normal wear and tear that comes with time.
As noted above, any activity that requires a sustained grip on an object can lead to irritated tendons on the outside of the elbow.
This may include professional or occupational activities like food preparation, construction, manufacturing work, gardening or any type of work that requires physically gripping a tool.
Tennis elbow is fairly common in other sports, such as weightlifting, rock climbing and athletic activities that involve throwing an object, as well.
This form of tendinitis typically affects a person’s dominant arm, though both arms can be affected depending on an individual’s activities.
Common Tennis Elbow Symptoms
It can be especially easy to ignore the early symptoms of tennis elbow because the associated soreness and pain can dissipate as a person’s forearm muscles and soft tissue get warm with activity.
However, disregarding the condition will likely worsen the situation, especially if a person continues to engage in the activity causing the inflammation.
Tennis elbow symptoms can include some of the following:
- Pain on the outside of the elbow, typically on a person’s dominant arm
- Swelling, inflammation or stiffness in the elbow
- Soreness or pain that radiates into the forearm and wrist
- Numbness or tingling in the fingers
- Weakness in the hand, wrists, or both
- Pain that continues even when not using the arm
- Moderate to severe range of motion issues in the elbow
There are a range of treatment options for tennis elbow. Without treatment, though, the symptoms of this type of tendinitis can make simple movements that require a grip or an extension of the arm very painful.
Tennis Elbow Treatment
Diagnosing lateral epicondylitis is done by a physical examination, a discussion of the symptoms and might involve x-rays or an MRI to rule out any other issues that can lead to outer elbow pain.
The first recommendation for people with lateral epicondylitis is to limit or stop activities and movements causing pain and inflammation. This is sometimes enough to allow the soft tissue to heal.
The Most Common Tennis Elbow Treatment Approaches for Lateral Epicondylitis include:
RICE stands for Rest, Ice, Compression, and Elevation. Along with resting the elbow, ice or a cold compress applied to the sore elbow can help reduce inflammation, swelling and pain, especially right after activity.
Wrapping the elbow with a compression bandage and elevating it above the heart while resting it can help to decrease swelling and improve healing.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are over the counter medications like ibuprofen and naproxen that are useful for relieving pain and inflammation. Advil, Motrin, and Aleve are all recommended and will not cause any adverse side effects.
3. KT Tape for Tennis Elbow
Kinesiology Tape or KT Tape for tennis elbow can add support, reduce pressure, and increase circulation when applied to the top of the forearm and around the elbow.
4. Tennis Elbow Brace or Strap
A tennis elbow brace placed around the forearm below the elbow is designed to reduce pain and discomfort while adding support to affected area.
Sometimes referred to as a tennis elbow strap, there are also larger models that are designed like a compression sleeve that extend above and below the elbow down to the forearm.
5. Shockwave Therapy (ESWT)
Extracorporeal Shock Wave Therapy ESWT, also called EPAT Therapy, delivers impulse pressure waves deep into the irritated soft-tissue of the forearm to improve blood flow and reduce inflammation that causes pain.
Shockwave Therapy is a noninvasive procedure that speeds up the healing process without any negative side effects, such as scarring or infection that can result from invasive procedures like surgery.
ESWT can be especially useful for athletes or essential workers who are unable to take a lot of injury-related downtime.
6. Platelet-Rich Plasma Therapy (PRP)
Platelet-Rich Plasma Therapy, or PRP, is a minimally invasive regenerative medicine therapy that uses biologics, such as blood platelets taken from the patient and injected into the affected area. This process helps to repair the tendons and works well when combined with EPAT Therapy.
7. Physical Therapy
Tennis elbow physical therapy is often used in tandem with many of the above treatments when an injury first appears, and can be effective after recovery.
Physical therapy is important for building strength, learning exercises and stretches for tennis elbow, and developing proper techniques that will aid in avoiding further injury.
8. Cortisone Injections
Cortisone, a very powerful steroidal anti-inflammatory, may be injected near the lateral epicondyle to reduce swelling and pain. Some individuals experience different durations of pain and swelling relief with this method.
However, the number of shots a person can receive is limited since steroids can cause damage to other soft tissues.
Most people will see improvement with most of the above treatments, which is why tennis elbow surgery is something of a last resort.
There are several different surgery procedures available depending on a person’s particular condition, though it’s important to consider the associated recovery downtime and the inherent risks of infection, nerve damage, and loss of strength among others.
Tennis elbow pain and symptoms caused by lateral epicondylitis are quite common among people who are active, especially as they get older. While these treatment methods should provide relief, it’s always important to see a doctor at the first signs of pain to verify the reason for the injury.
Tennis Elbow image courtesy of Bruce Blaus.