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Tennis Elbow

What is tennis elbow?

Tennis elbow is the inflammation and/or degeneration of the tendon around the bony bump on the outer side of the elbow. This bony lump is called the lateral epicondyle and the medical name for tennis elbow is therefore “Lateral Epicondylitis”

What are the symptoms?

Tennis elbow is characterised by pain and tenderness in the elbow and in the back of the upper forearm. Sometimes pain may be felt down the arm towards the wrist. Symptoms vary in severity between individuals.

The pain  caused by tennis elbow normally lasts for 6 to 12 weeks. Some people may have pain as little as 3 weeks while others may experience discomfort in the joint for several years.

What causes tennis elbow?

About 5 in 1000 adults develop tennis elbow each year. It mainly occurs between the ages of 40 and 60. Women and men are equally affected.

Contrary to what the name suggests you do not have to play tennis to develop this condition. In fact, tennis elbow is more commonly seen in non-tennis players! Excessive or repeated use of the muscles that move the wrist backwards can cause injury to the tendons, leading to tennis elbow. This includes sporting activities such as tennis, squash, badminton, as well as manual work such as carpentry, painting, chopping wood, bricklaying, repetitive use of a screw driver, sewing and knitting or working at a computer.

How is tennis elbow diagnosed?

To diagnose tennis elbow your doctor/physiotherapist will examine the affected arm and discuss symptoms with you. They will check for pain in the area around the elbow by pressing on it and bending  the hand backwards against pressure to see if this causes pain.

How is tennis elbow treated?

Modify activities that bring on your symptoms – Recognise and rest from activities that bring on pain in order to reduce inflammation so that the tendon injury can heal. Modifying job activities and cutting out repetitive movements of the hand can be helpful.

Cold therapy – Apply ice packs/frozen peas wrapped in a towel over the painful area for 10 minutes. Repeat this 3 to 4 times a day for 3 days.

Anti-inflammatory and other painkillers – Please tell your pharmacist about any other drugs you are using. Ask whether they might be affected by these new drugs.

Steroid injection – Your doctor may suggest a steroid injection which is helpful in easing pain in the short term. These are done in our practice by Drs Haldane and Scott.

Physiotherapy – Studies have shown that physiotherapy may not be as good as a steroid injection at relieving pain in the short term but may be superior to steroid injections in the long term. Your physiotherapist will teach you to do gentle stretching exercises and graded muscle building exercises. The wrist extensor stretch can be especially helpful: Hold the arm with the elbow straight and the palm facing down. Push downward on the back of the involved hand until a stretch is felt in the muscles on the outside of the forearm. Hold for 15 seconds and repeat 3 to 5 times in a session. Repeat the session 2 or 3 times per day.

Surgery – Is rarely indicated and only in longstanding cases will it be considered. Surgery has a variable outcome.

Forearm supports – A forearm support or clasp may be helpful and are available at local pharmacies or on the internet.

 

Reproduced with the kind permission of NHS Fife Physiotherapy services.