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OVERVIEW

What is tennis elbow?

Tennis elbow, also known as lateral epicondylitis, occurs when the tendons that attach the muscle to the bone on the outside (lateral) part of the elbow swell or tear. This weakens the connection and puts greater stress on the area, causing pain when the muscles are used to lift, grip or twist.

SYMPTOMS

What are the symptoms of tennis elbow?

Tennis elbow begins as an ache on the outside of the elbow. It gradually gets worse over a period of several weeks or months until it is a severe burning pain. You may notice pain moving from the outside of your elbow to your forearm and back of your hand when you make a grasping or twisting motion.

As the condition worsens, your grip may weaken, or you may feel pain even when lifting light objects, such as a small book or coffee cup. Pressing on the outside of your elbow may increase pain.

CAUSES & RISK FACTORS

What causes tennis elbow?

Tennis elbow is an overuse injury. An overuse injury occurs when repeated movements cause inflammation and pain in joints and tendons. Any type of repeated motion of the wrist or forearm or repeated stress on the tendons can cause tennis elbow. It can be caused by many activities, besides tennis. Other types of sports and jobs that involve repeated wrist motion can also cause tennis elbow. In some cases, the tendons can swell after a direct blow to the elbow. And sometimes, the condition isn’t related to any activity.

Who is at risk for tennis elbow?

Anyone who uses repeated hand motions is at risk. Examples include painters, meat cutters, carpenters, musicians, manicurists and dentists. People who work on an assembly line or use computers also are at risk.

Playing tennis is one of the ways you can get tennis elbow. Other sports that can lead to tennis elbow include other racquet sports (such as racquetball or squash) and fencing.

Tennis elbow can occur at any age, but is most common in people 30 years to 50 years of age. It affects both men and women.

DIAGNOSIS & TESTS

How is tennis elbow diagnosed?

Your healthcare provider will ask you questions about what types of activities cause pain in your elbow. They will apply pressure on different parts of your arm to check for pain and stiffness. They may also ask you to move your arm, elbow, wrist and fingers. They may take an X-ray of your elbow to make sure your pain isn’t due to a break or a fracture.

TREATMENT

What are the treatments for tennis elbow?

You can try some things at home to relieve swelling and pain:

• Rest the area by avoiding the movement that has caused the condition
• Take an over-the-counter medicine that reduces swelling, such as ibuprofen (brand names: Advil, Motrin), naproxen (brand name: Aleve) or aspirin
• Use an ice pack for 15 to 20 minutes, 3 times a day
• Wrap your elbow in a compression bandage, such as an Ace bandage
• Do gentle stretching exercises several times a day

If these treatments do not help, then your healthcare provider may suggest:

• Keeping the area still for 2 to 3 weeks with a splint of the forearm and elbow
• Getting a steroid injection to relieve swelling and pain
• Using pulsed ultrasound to break up scar tissue, promote healing and increase blood flow in the area

Once the pain is relieved, physical therapy can help strengthen muscles and tendons. These include stretching, range-of‑motion and strengthening exercises. Most people improve in 4 to 6 weeks.

When should I contact my healthcare provider?

Contact your healthcare provider if:

• The pain doesn’t improve or gets worse after a week or so of home care
• The area becomes red or swollen
• You have trouble moving your arm
• You see a lump or bulge on your arm

Will I need surgery for tennis elbow?

Surgery is not usually needed. But if you have pain that keeps you from living normally or that doesn’t improve after 6 months of treatment, your healthcare provider may suggest surgery.

Usually, the surgery is done on an outpatient basis, which means you won’t have to stay in the hospital. The operation involves making a small cut on the outside of the elbow, removing the damaged tendon tissue and reattaching normal tendon tissue to bone.

After surgery, you will need physical therapy to stretch the elbow and bring back range of motion. Because the elbow will be weak at first, you will need to do exercises to strengthen it. Most people are able to resume normal activity 4 to 6 months after surgery.

PREVENTION

How can I prevent tennis elbow?

You can avoid getting tennis elbow by maintaining good strength and flexibility in your arm muscles. You can use light weights to help strengthen your forearm and wrist muscles. Avoid repetitive movements or wear a splint during activities that seem to make the condition worse. And, make sure you warm up before using your arm for sports or other repetitive activities.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• What could have caused my symptoms?
• What is the best treatment option for me?
• How long before I can expect relief from my symptoms?
• When can I return to my sport (job, etc.)?
• Is it possible that my symptoms could return?
• Is it safe for me to exercise? What kind of exercise should I do?