A tennis elbow is a non-bacterial inflammation of a tendon at the level of the elbow. This tendon is connected to the hand extensor muscle and is used in stretching the elbow and bending the hand. A tennis elbow hurts when pinching the hand, bending the wrist backward or turning the forearm outward.
Cause
A tennis elbow is usually caused by overloading the wrist extensor muscles. This overload manifests itself by a painful attachment of one or more tendons to the elbow and adhesions in the muscles involved. Small tears arise in the tendons around the elbow. The overload can occur when a person keeps repeating the same movements (computer work) or when there is a sudden heavy load onto the muscles (for example, playing tennis without proper warming-up or due to injury).
Symptoms
Anyone who has a tennis elbow, probably has pain at the outside of the elbow, particularly when extending the elbow or bending the wrist. This pain may radiate to the forearm, wrist and hand and sometimes also to the upper arm and shoulder. Furthermore, it may be that a person has less strength in the arm.
Diagnosis
A known test that the general practitioner can do, in order to make the diagnosis of tennis elbow, is pressing with one hand on the attachment of the tendon at the elbow and then ask to move the hand towards the back of the hand. When this hurts a lot, it’s often a confirmation of the diagnosis.
Treatment
A tennis elbow can pass on its own when there is no overload anymore, but it may take a long time. It's often advised to put ice onto the elbow. The doctor can also prescribe anti-inflammatories in order to reduce the inflammation in the elbow. Probably, the patient is also referred to a physical therapist, who will try to treat tennis elbow using massages, exercises and mobilization. The patient can also wear a brace or splint around the elbow to reduce the symptoms of tennis elbow, but it’s generally recommended to keep the elbow moving.
There are also other treatment options, but the effectiveness of these may vary. For example:
- Injecting corticosteroids into the elbow. Thereby reducing the symptoms within a short period, but after some time the tennis elbow may come back again.
- Shockwave therapy. The inflammation is treated with shocks or sound waves, but it isn’t known whether it really works.
- Alternative forms of treatment, such as acupuncture or massage. But the effect is not yet scientifically proven.
Prognosis
When giving rest to the arm and avoiding activities that cause the symptoms, there are good chances that the tennis elbow decreases with time. Pain of tennis elbow usually lasts six to twelve weeks, because tendons heal slowly. But in some people, the pain can last longer (between six months and two years). In practice, a tennis elbow can actually always heal spontaneously, but treatment methods can provide faster improvement of symptoms. Once a person has had a tennis elbow, it may come back again.
Considerations
- Keep using the arm normally as much as possible. Exercising is good, even if there is pain. With exercise, the muscles are kept in good shape. So don’t wear a sling.
- If certain movements hurt, do them as gradually as possible.
- If force or lifting hurts too much, then try using the arm in a different position. For example, lifting underhand instead of upperhand.
- The sore spot at the elbow can optionally be cooled with ice.
