Tennis elbow
Tennis elbow isn't just caused by playing tennis. It is caused
by a strain to the extensor tendons in the forearm. Any
activity that involves gripping and twisting of the forearm can
cause this type of strain. Anybody can get tennis elbow but it is
most common in people between the ages of 40 and 60.
In tennis elbow (lateral epicondylitis) the tendons
become inflamed where they join the bony part on the outside of
your elbow joint (lateral epicondyle). Golfer's elbow (medial
epicondylitis) is a similar condition that affects the inside of
the elbow joint near the funny bone.
Tennis elbow usually improves with the help of simple
painkillers and other home treatments, but injections and
physiotherapy are available for more persistent pain. Although
tennis elbow is painful it shouldn't do any lasting damage and it
doesn't lead to arthritis.
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Tennis elbow symptoms
Symptoms vary – you may have mild discomfort when you move your
arm, or the pain may be bad enough to disturb your sleep. The
outside of your elbow will feel tender to the touch and there may
be swelling in the tender area. You may also have pain further down
your forearm.
Repeated movements of the wrist will make the pain worse,
especially if combined with resistance – for example, a tennis
stroke. However, even something simple like using a paint-roller on
a ceiling can strain the tendons.
If you are experiencing tingling in the arm or fingers this is
more likely to be some other condition, for example, pressure on a
nerve in the neck (possibly caused by cervical spondylosis) or at
the wrist (carpal tunnel syndrome).
How is tennis elbow diagnosed?
Your doctor will ask about your symptoms and about any
activities that might have caused the strain.
The diagnosis is usually straightforward, and tests aren't
normally necessary. If your doctor does ask you to go for x-rays or
blood tests, it will usually be to rule out other conditions.
Tennis elbow treatments
Tennis elbow usually clears up with self-help treatments, but if
these don't help, your doctor will be able to suggest other
treatments.
Drugs
A steroid injection (cortisone) can be given into the tender
area if other measures don't relieve the pain. One injection is
probably all you'll need though you may still need to rest your
elbow for 2–3 weeks afterwards. There is a slight possibility that
the pain will become worse for a few hours after the injection,
occasionally lasting for up to 48 hours.
If steroid injections or physiotherapy haven't helped to
reduce symptoms then, prior to considering surgery, your
doctor might prescribe a transdermal patch containing nitric oxide.
Nitric oxide has recently been shown to help tendon healing.
Physical therapies
Physiotherapy and, occasionally, manipulation, for example by a
chiropractor or osteopath, can be helpful for more persistent
pain.
Surgery
A minor tendon-releasing operation may be an option if other
treatments don't help, but this is only rarely necessary.
Self-help and daily living
Simple home treatments are probably all you'll need to clear up
your tennis elbow.
- If you can, avoid repetitive movements of the elbow and hand.
If not, wearing a support called an epicondylitis clasp during
those activities can reduce the strain
- If your work involves repetitive movements that might be
causing strain it's worth discussing this with an occupational
therapist. They'll be able to advise on ways to support your
tennis elbow while it's healing
- Putting either a hot water bottle or ice packs on to the tender
area for 10 minutes twice a day can ease the pain – try both to
find out what works best for you
- Mild painkilling tablets such as ibuprofen will usually help,
as will anti-inflammatory gels rubbed into the painful area. Ask
your chemist about these.
