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Tennis Elbow

Overview

Tennis elbow pain happens where the tough cords (tendons) that connect forearm muscles to a bony part on the outside of your elbow. Tiny tears and swelling (inflammation) in these tendons can weaken them, causing the pain. It's sometimes called lateral epicondylitis.

This overuse injury is often linked to repeatedly moving your wrist and arm. While the name suggests it's only for tennis players, many people get it doing other repetitive tasks. Jobs like plumbing, painting, carpentry, and even butchering can put stress on the tendons and cause the problem. Sometimes, there's no obvious reason for it.

The pain often starts near the bony part on the outside of your elbow and can extend into your forearm and wrist. It's a common problem, and most people find relief with simple treatments.

Rest, over-the-counter pain relievers, and physical therapy are often enough to ease tennis elbow symptoms. If those don't work, or if the pain seriously interferes with your daily life, a doctor might suggest a shot of medication or surgery.

Symptoms

Tennis elbow pain often starts on the outside of your elbow and can spread down into your forearm and wrist. This pain and weakness can make everyday tasks difficult. For example, shaking hands, gripping things, turning doorknobs, or even holding a coffee cup might become painful or challenging. If simple home remedies like resting, applying ice, and taking over-the-counter pain relievers don't help reduce the elbow pain and tenderness, it's important to see a doctor.

When to see a doctor

If simple home remedies like rest, ice packs, and over-the-counter pain medications don't help reduce your elbow pain and tenderness, it's important to see a doctor. Taking care of yourself at home is a good first step, but if the pain persists, professional medical advice is necessary. A healthcare provider can properly diagnose the cause of the pain and recommend the best course of treatment.

Causes

Tennis elbow, a painful condition, is usually connected to repetitive movements and strained muscles. While the exact cause isn't always clear, it frequently involves overuse of the muscles in your forearm. These muscles help straighten and lift your hand and wrist. Over time, repeated forceful use can lead to tiny tears and damage in the tendon – the tough tissue connecting the muscles to the bony area on the outside of your elbow.

Many activities can trigger tennis elbow symptoms. For example, playing racket sports, especially using a poor backhand technique, can strain the forearm muscles. Similar strain can come from using plumbing tools, painting, driving screws, or even chopping meat. Even something as common as using a computer mouse too much can contribute.

In some cases, an injury or an underlying issue affecting the body's tissues might be involved. But often, the specific cause of tennis elbow isn't identified.

Risk factors

Tennis elbow, a painful condition affecting the elbow, is more likely to happen to some people than others. Here are some things that raise your chances:

  • Your age. While anyone can get tennis elbow, it's most frequently seen in adults between 30 and 60 years old. This age group often has a longer history of using their arms and hands for work and/or hobbies.

  • Your job. If your work involves repetitive arm and wrist movements, you're at higher risk. This includes many trades like plumbing, painting, carpentry, even butchery and cooking. Jobs that require you to use tools or equipment frequently can also contribute. The more you repeat these motions, the greater the risk.

  • Your hobbies and sports. Racket sports, like tennis, badminton, and squash, are common culprits. Not using proper technique or having the right equipment can significantly increase the risk. Playing these sports for more than two hours a day can also add to the problem. Even activities like gardening or using power tools for extended periods can cause strain.

  • Other factors. Smoking, being overweight or obese, and some medications can also increase your chances of developing tennis elbow. These factors can affect the overall health and strength of your body, potentially making you more vulnerable to injury.

These are just some of the things that can increase your risk of tennis elbow. If you have any concerns, talking to a doctor or physical therapist is always a good idea.

Diagnosis

If a doctor thinks another problem might be causing your symptoms, they might order X-rays, ultrasounds (sonograms), or other imaging tests. These tests create pictures of the inside of your body to help find out what's going on.

Treatment

Tennis elbow often gets better on its own, but sometimes it needs more help. If over-the-counter pain relievers and home care aren't enough, physical therapy is a good next step. If the pain persists, a doctor might suggest a procedure, such as an injection or surgery.

If your tennis elbow is connected to your tennis game or job, a doctor might look at how you're playing or working to help you avoid further injury. This includes things like your technique, equipment, or posture. The goal is to reduce the strain on the injured area.

Physical therapists can help you with exercises to strengthen the muscles and tendons in your forearm. A brace or strap can also help reduce stress on the injured area.

There are several different ways to treat tennis elbow, beyond physical therapy:

Injections: Doctors might inject the affected tendon with different substances to help reduce inflammation and pain. These include:

  • Corticosteroids: These are powerful anti-inflammatory medicines.
  • Platelet-rich plasma (PRP): This involves taking your own blood, separating the platelets, and injecting them back into the injured area. Platelets are important for healing.
  • Less common options: Other less frequently used injections include botulinum toxin A (Botox) and prolotherapy, which uses a solution like sugar water or salt water.

Other Procedures:

  • Dry needling: A thin needle is gently inserted into the injured tendon in several places. This can help reduce pain and promote healing.
  • Needle fenestration: Using ultrasound guidance, a needle is repeatedly inserted into the tendon. This helps start the healing process.
  • Ultrasonic tenotomy (TENEX): Similar to needle fenestration, this procedure uses ultrasound to guide a special needle into the damaged area. The needle creates vibrations that liquefy the damaged tissue, which is then removed.
  • Extracorporeal shock wave therapy (ESWT): Shock waves are directed at the injured area to reduce pain and encourage healing. The shock waves are delivered through a device placed on the skin.

Surgery: In some cases, surgery might be necessary if other treatments haven't worked after about 6 to 12 months. Surgery can involve either a large incision (open surgery) or several smaller incisions (arthroscopic surgery) to remove damaged tissue.

Recovery: No matter the treatment, exercises are crucial for building back strength and regaining full use of your elbow. Your doctor or physical therapist will create a personalized recovery plan to help you get back to your normal activities.

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Disclaimer: August is a health information platform and its responses don't constitute medical advise. Always consult with a licenced medical professional near you before making any changes.

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