What Is Tennis Elbow?

Tennis elbow is painful weakening of the tendons that join your forearm muscles to your bones. It happens when you work your elbow too much by repeating certain motions. You might hear your doctor call it lateral epicondylitis.

Despite the name, tennis causes only about 5% of cases. You can get it after doing any kind of repetitive movement, like painting or using hand tools. Tennis elbow is a common injury that usually needs only minor treatment, but it takes time and rest to heal.

The basic pathology of tennis elbow involves an imbalance between the forearm muscle strength and the load put on the forearm muscles. The symptoms of tennis elbow are thought to develop due to the degeneration of chronically injured tendon fibers with micro-tears leading to inflammation and pain near the bony lump (lateral epicondyle) on the lateral aspect of the elbow joint. However, tendon tears are rarer than expected.

Where Does Tennis Elbow Cause Pain?

The pain is focused on the outside of your arm, where your forearm meets your elbow.

It’s related to a muscle and tendons in your forearm. Tendons connect your muscles to your bones. When you repeat certain arm movements, the tendons at the elbow end of a certain muscle — the extensor carpi radialis brevis (ECRB) muscle — may get small tears.

The tears may put stress on the rest of your arm, making it painful to lift and grip things. If you don’t get treatment, the pain can last a long time.


What Are the Symptoms of Tennis Elbow?

The most common symptom of tennis elbow is an ache on the outside of your elbow. Over time — from a few weeks to a few months — the ache can turn into a constant pain. The outside of your elbow may be too painful to touch. The pain might go into your forearm and wrist. You may feel pain when doing nothing at all, but usually pain is triggered by particular movements, especially wrist movements that tug on the tendon at the elbow. You can have Tennis elbow in one or both arms.

If you have symptoms after a week or so, or if they get worse, it’s time to call your doctor.

What Are the Causes and Risk Factors for Tennis Elbow?

Tennis elbow affects up to 3% of people, mostly between the ages of 30 and 50.

Any repetitive, forceful motion that pulls on the tendon and muscle around your elbow can cause tennis elbow. In tennis, hitting a backhand puts some stress on your forearm muscles, which clench when you hit the ball. If your technique is off or if you grip the racquet too tightly, it puts more stress on the tendons that connect your forearm muscles to your elbow. That can cause the tendons to get small tears.

You can get tennis elbow from playing other racquet sports, such as squash or racquetball. You can also get it from jobs or activities that involve repetitive arm motion, such as:

  • Cutting down trees with a chainsaw
  • Painting
  • Carpentry
  • Playing some types of musical instruments
  • Kitchen work, such as cutting with a knife
  • Plumbing
  • Working on cars
  • Working on an assembly line

A direct blow to your elbow can also make the tendons swell.


How do I get the condition?


How long does it last for?


What do I do when I have it?


X-rays, magnetic resonance imaging (MRI), and electromyography (EMG) may be required to diagnose tennis elbow and rule out pain from conditions such as rheumatoid arthritis, neck injuries, or nerve compression. Tennis elbow usually improves without treatment (a self-limiting condition), but some treatments may improve symptoms and speed up recovery.

Individuals should rest their injured arm and stop any activity causing the problem. Warm-up exercises and gently stretching arm muscles before playing a sport that involves repetitive arm movements are necessary. Wearing a tennis elbow splint while using the affected arm (not while resting or sleeping) could prevent further damage to the elbow tendons.

Therapeutic ultrasound, holding a cold compress such as ice wrapped in a towel against the elbow, or muscle stimulating techniques for a few minutes several times a day can help ease the pain and improve muscle healing. In addition, taking painkillers, such as paracetamol, may help reduce mild pain. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can also be used to help reduce inflammation.

  • Corticosteroid medications. They’ll inject these into the area to help with swelling and pain.
  • A splint or brace. You’ll wear this on your arm to help your muscles and tendons rest.
  • Ultrasound. This treatment can break up scar tissue, increase blood flow, and promote healing.

Up to 95% of people who have tennis elbow get better without surgery. But you might need it if you still have pain after 6 to 12 months. Your doctor can remove damaged tissue through cuts in your arm.

How Can I Prevent Tennis Elbow?

Some small changes might help lower your risk of tennis elbow.

  • Keep your arms and wrists strong and flexible. Build strength with light weights. Warm up and stretch before any activity, especially one that involves making the same motions over and over.
  • Try not to make repetitive movements.
  • If you play a sport with a racquet, have an expert check your equipment to be sure it’s the right size and fit.
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