What is Tennis Elbow?
Lateral epicondylitis, commonly known as tennis elbow, is a condition affecting the extensor carpi radialis brevis muscle and its tendon. The common origin point of the wrist extensor muscles, which pull the wrist backward, is located on the outer side of the elbow at a region called the lateral epicondyle. Trauma and repetitive strain in this area can cause injuries and small tears, leading to tennis elbow.
What Causes Tennis Elbow?
Overuse: It occurs due to microtraumas caused by excessive strain on this tendon. Inflammation happens as a result of stress and trauma where the tendon attaches. Repetitive gripping, holding, activities such as cutting, painting, or certain ways of dressing are physical movements that can cause this condition.
Trauma: Blows to the tendon attachment at the elbow can cause tennis elbow. Sudden, forceful movements involving this muscle can also result in lateral epicondylitis.
Who Gets Tennis Elbow?
It is most common between the ages of 30 and 50. Although it often occurs in athletes involved in racket sports, it can affect anyone performing repetitive and strenuous wrist movements. Any profession or activity involving more than two hours of stressful wrist movements per day may develop tennis elbow. It is commonly seen in painters, plumbers, carpenters, and even in women who do heavy housework.
What are the Symptoms of Tennis Elbow?
Though it may seem like a simple condition, tennis elbow can significantly reduce quality of life and prevent daily activities. Patients often complain of severe pain in the elbow when shaking hands.
The main symptom is pain spreading from the bony prominence on the outer edge of the elbow down toward the forearm. The pain typically worsens when the wrist is extended backward against resistance. Weakness in the arm muscles may accompany the pain. The pain can start suddenly after a single strenuous movement or begin 24-72 hours after prolonged stressful activity. Initially mild, the pain will increase over weeks or months if the stressful movements continue. In advanced stages, even shaking hands or turning a doorknob can cause severe pain.
How is Tennis Elbow Diagnosed?
The doctor usually makes the diagnosis with a detailed history and physical examination. To exclude other underlying causes, elbow X-rays may be requested. In rare cases, MRI and EMG tests may be necessary.
How is Tennis Elbow Treated?
If symptoms are not very severe, treatment involves rest, ice application, and stopping the activity or sport causing the problem. Short-term use of NSAIDs (anti-inflammatory drugs) may help. Numerous braces and elbow supports have been developed for tennis elbow treatment. All aim to reduce the load on the injured area. These bands should be worn during activity and removed at rest. They should be applied near the elbow at the location recommended by the doctor, not directly on the painful area.
If pain persists after 4-6 weeks of treatment, other options may be considered, such as steroid injections into the affected area.
Physiotherapy often includes shockwave therapy. Ultrasound and heat treatments may also be beneficial. Additionally, strengthening and stretching exercises should be applied.
About 85-90% of tennis elbow patients recover with conservative treatment methods. Patients who do not respond to at least six months of medical treatment and injections should be evaluated for possible surgery.