Tennis Elbow - Pain on the Outer Side of Elbow

Tennis Elbow, clinically known as Lateral Epicondylitis, is a condition caused by overuse of Arms, Forearms, and Hand Muscles. The disorder derived its name from the famous sport, as it imposes a significant problem to some tennis players. However, playing tennis is not the only activity which causes pain on the Elbow. Any activity which places repetitive stress on the Elbow Joint can result in tears and inflammations near the bony area on the outside of the Elbow. The pain may also spread to the Forearm and Wrist. Athletes, plumbers, carpenters, painters, butchers and many other professionals involved in activities requiring repetitive Arm, Elbow, Wrist, and Hand movement, are vulnerable towards occurrence of Tennis Elbow.

Causes

Any activity that involves repeated contraction of forearm muscles for raising the hands or twisting the wrists can cause Tennis Elbow. Some of the activities that increase the risk of developing Tennis Elbow are as follows:

1. Throwing Sports, such as Discus
2. Racket Sports, such as, Tennis, Badminton, and Squash
3. Painting
4. Manual Work, such as, Plumbing, Brick-laying, or Driving Screws
5. Cutting of cooking ingredients especially meat
6. Repetitive use of Shears while gardening

Signs and Symptoms

The major symptom of Tennis Elbow is the pain that radiates from the outside of the Elbow and slowly travels down to the Forearm and Wrists. The patient may experience severe pain while carrying out the following activities:

1. Lifting or bending the Arms
2. Twisting the Forearms for turning a door knob or opening a jar
3. Shaking hands or squeezing objects
4.  Writing
5. Gripping small objects

Specialist

One should consult a General Physician or Orthopedic for Tennis Elbow.

Diagnosis

The Specialist will carry out the following diagnosis to assess the patient's condition: History: The doctor will require information regarding symptoms, medical history, and description of pain experienced by the patient. Physical Examination: This involves carrying out a physical examination of the symptomatic elbow. The doctor may also apply pressure on the affected area or move the Elbow, Wrist, and Fingers in various ways. Laboratory Tests: In most of the cases, medical history and physical examination render sufficient information for treatment. However, in rare cases, doctors may advice to carry out Imaging Tests such as X-Rays. Blood Tests do not provide any information in such conditions.

Treatment Modalities Available for Management of the Disorder

The choice of treatment options depend on a variety of factors, such as, age of the patient, use of other drugs, overall health, occupation, medical history, and severity of pain. Tennis Elbow rarely requires surgery, except in cases of acute and persistent pain. Mostly medicinal treatments, such as, Topical Anti-Inflammatory Gels, Topical Cortisone Gels, Forearm Bracing, Splint, Support Bandage, Non-Steroidal Anti-Inflammatory Drugs, and Cortisone Injections, help in reducing pain and inflammation. Physical Therapy comprising Massages, Manual Therapy Techniques, & Strengthening Exercises help in relieving stiffness and encourage blood flow to the Arm. Self-care measures, such as, avoiding strenuous activities, resting the arm, and holding a cold compress against the elbow for a few minutes several times a day, also helps in alleviating pain. However if none of these options help in improving the condition, even after 12 months of extensive conservative therapy, the doctor may resort to surgery for permanently removing the damaged tissue.

Known Complications

If left untreated, Tennis Elbow can lead to Chronic Pain specially while lifting or gripping objects.

Precautions

People diagnosed with Tennis Elbow should undertake the following precautions:

1. Take proper rest and immediately stop activities that inflict pain on the Elbow. Try finding out an alternative way of carrying out the job or activity.
2. Use proper equipment and techniques in sports and other jobs.
3. Avoid using Wrist and Elbow. Instead, spread the load to the larger muscles of the Arm and Shoulder.
4. Wear a Brace or Splint while using the arm and remove it while sleeping/resting.
5. Strictly follow the strengthening exercises regimen suggested by the Physiotherapist.

Dietary and Physical Activity Requirements

Patients suffering from Tennis Elbow should strictly avoid all activities that cause pain to the sore elbow. Overuse of Wrist and Elbow might aggravate the condition. If the patient has undergone surgery, then he needs to provide rest to the arm for a few weeks before starting the Rehabilitation Program.

Prevention of the Disorder from Happening or Recurring

The following measures help in preventing Tennis Elbow from developing or recurring:

1. While playing a sport that requires repetitive movements, such as, Tennis or Squash, take proper coaching advice to improve use of techniques and to avoid elbow disorders.
2. Before starting a sport, carry out warm up and stretching exercises to avoid injury.
3. Use of lightweight rackets and tools and enlarging one's grip size on them helps in avoiding excess strain on tendons.

Support and Help given by the Caregiver

Tennis Elbow is a self-limiting condition which can improve in course of time. However, it often lasts for several months, forcing the patient to experience bouts of pain even while performing simple jobs. Caregivers should assist the patient in carrying out the day-to-day activities, so that the patient can reduce stress and abuse on the Tennis Elbow.