Lateral Epicondylitis, more colloquially termed ‘tennis elbow’, describes an overuse disorder that causes trauma to the elbow, typically as a result of repeated stress to the tendons. Tendons are found all over our bodies including our elbow joints and are comprised of strong cords of tissue. The tendons connect muscle to bone.
The elbow joint is formed of the bone in the upper arm, (the humerus), and the bones of the lower arm (the radius and the ulna). Bony prominences can be found at the bottom of the humerus at the elbow joint, these bumps are called epicondyles. The bump on the outside of the elbow is termed as the lateral epicondyle and is where several of the forearm extensor muscles attach. Tennis elbow describes a condition that affects the muscle attachment on the lateral epicondyle, the bony bump on the outside of the elbow. Inflammation and degeneration of the tendons that connect the muscles of the forearm to the elbow in this area, can result in pain and tenderness of the lateral epicondyle.
The muscles on the lateral epicondyle are subject to general heavy use as they are responsible for the extension of the wrist and fingers. This makes its soft tissues particularly prone to wear and tear, a factor often accelerated by particular sports and activities.
As its name suggests, tennis elbow is common amongst tennis players and those who participate in other types of racket sports, however, it can also manifest as a result of other sporting and non-sporting activities, in jobs such as carpentry, painting and decorating for example.
Tennis Elbow Symptoms
In most cases, the pain begins mildly but slowly worsens over the weeks or months following the initial onset of symptoms. Commonly reported symptoms include pain or a burning sensation on the outer side of the elbow, that often worsens at night-time and patients report a weak grip. Pain is typically felt whilst bending or straightening the arm and elbow, or when grasping or lifting items. This can hinder everyday activities such as getting dressed, working, driving, resting, and sleeping.
Tennis Elbow Causes
If tennis elbow is the result of playing racket sports, it is often due to poor technique or improper equipment, or due to the force of the ball as it hits the racket. Poor backhand stroke, weak shoulder and wrist muscles or using a racket that is too tightly strung, can all contribute towards tennis elbow. Damage to the lateral epicondyle can also occur with other types of repetitive and gripping activities caused by occupation or activities.
Sometimes a direct blow to the elbow may result in the swelling of the tendons.
Age may be a factor. Most people that get tennis elbow are between the ages of 30 and 50 years old. In some cases, the cause of tennis elbow is idiopathic (unknown).
In most cases, tennis elbow is diagnosed by a physical examination and an evaluation of symptoms. During the physical examination, a doctor or physiotherapist will ask the patient to perform specific activities to see if any pain is experienced. They may also apply pressure to the affected area to check if there is any pain or tenderness.
In some cases, certain tests may be required to help reach a diagnosis. This includes ruling out any other possible conditions. An MRI scan, for example, may be used to check the tendons and show how severe the damage is. If there is any suspected nerve pain, nerve conduction studies or EMG tests may be useful to ascertain the nerve function. X-rays may be used to check for any signs of arthritis in the elbow.
Tennis Elbow Treatment
Treatment typically includes rest and avoiding any types of movement that may exacerbate symptoms.
Over the counter painkillers such as paracetamol or anti-inflammatory medication can be helpful. Some people also find hot or cold packs offer effective pain relief. A splint or brace can sometimes be used to help the muscles and the tendons to rest.
Physiotherapy can be extremely helpful in the treatment of tennis elbow and is the primary mode of treatment, offering effective pain relief and rehabilitation. Targeted stretches and exercise can not only help relieve the pain and stiffness but also speed up the healing and improve muscle function. Once the initial painful symptoms have subsided, specific exercises can help to strengthen the muscles and aid the recovery process.
ESWT therapy is used to treat a wide range of disorders including tennis elbow. It describes a form of non-surgical, minimally invasive treatment aimed at providing pain relief and accelerating the healing process. It works by delivering impulses of energy that target specific soft tissue injuries.
Corticosteroid injections treat a variety of joint and soft tissue disorders causing pain and inflammation. They may be offered to treat severe symptoms caused in tennis elbow in conjunction with physiotherapy.
We offer a wide range of services including physiotherapy, massage therapy, ESWT, and corticosteroid injections to treat various physical disorders including tennis elbow. For more information or to discuss your requirements with a member of our highly experienced team, get in touch today.