Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse.
Not surprisingly, playing tennis or other racquet sports can cause this condition. But several other sports and activities can also put you at risk.
Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.
Overuse. Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The extensor carpi radialis brevis (ECRB) muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example.
When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.
The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.
Activities. Athletes are not the only people who get tennis elbow. Many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle.
Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.
Age. Most people who get tennis elbow are between the ages of 30 and 50, although anyone can get tennis elbow if they have the risk factors. In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.
Unknown. Lateral epicondylitis can occur without any recognized repetitive injury. This occurence is called “insidious” or of an unknown cause.
The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.
Common signs and symptoms of tennis elbow include:
- Pain or burning on the outer part of your elbow
- Weak grip strength
- The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is most often affected; however both arms can be affected.
Your Great Lakes Orthopedics & Sports Medicine orthopedic physician will consider many factors in making a diagnosis. These include how your symptoms developed, any occupational risk factors, and recreational sports participation.
He or she will talk to you about what activities cause symptoms and where on your arm the symptoms occur. Be sure to tell your doctor if you have ever injured your elbow. If you have a history of rheumatoid arthritis or nerve disease, tell your GLO doctor.
During the examination, your doctor will use a variety of tests to pinpoint the diagnosis. For example, your doctor may ask you to try to straighten your wrist and fingers against resistance with your arm fully straight to see if this causes pain. If the tests are positive, it tells your doctor that those muscles may not be healthy.
Your GLO doctor may recommend additional tests to rule out other causes of your problem.
These may be taken to rule out arthritis of the elbow.
Magnetic Resonance Imaging (MRI)
If your doctor thinks your symptoms are related to a neck problem, an MRI scan may be ordered. This will help your doctor see if you have a possible herniated disk or arthritis in your neck. Both of these conditions often produce arm pain.
Your doctor may order an EMG to rule out nerve compression. Many nerves travel around the elbow, and the symptoms of nerve compression are similar to those of tennis elbow.
Approximately 80% to 95% of patients have success with nonsurgical treatment.
If your symptoms do not respond after 6 to 12 months of nonsurgical treatments, your doctor may recommend surgery.
Most surgical procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to bone.
The right surgical approach for you will depend on a range of factors. These include the scope of your injury, your general health, and your personal needs. Talk with your doctor about the options. Discuss the results your doctor has had, and any risks associated with each procedure.
Open surgery is usually performed as an outpatient surgery. It rarely requires an overnight stay at the hospital.