Introduction
Tennis Elbow, or Lateral Epicondylitis, is a condition characterized by the deterioration of the tendon fibers that connect to the outer part of the elbow. Tendons, which are robust structures that link muscles to bones, do not stretch easily and are prone to degeneration from repetitive strain or trauma. While playing racquet sports is often associated with this condition, it can arise from various activities.
Anatomy
The forearm muscles attach to the outer side of the elbow bone (the Lateral Epicondyle) via a tendon. One key muscle involved is the Extensor Carpi Radialis Brevis, which helps in raising the hand at the wrist. These muscles, known as “wrist extensors,” facilitate hand movements like extending the wrist. Overuse of these muscles can lead to microscopic tears in the tendon, resulting in weakness, swelling, and pain at the elbow.
Causes
Tennis Elbow typically affects individuals aged 30 to 50. It is caused by chronic strain on the forearm muscles, particularly the Extensor Carpi Radialis Brevis. Repeated motions, especially those involved in playing tennis or other racquet sports—such as backhand strokes or serves—can lead to tendon degeneration. However, many cases arise without an identifiable cause.
Symptoms
Those with Tennis Elbow often report intense burning pain and tenderness on the outer elbow and forearm. Symptoms usually begin subtly and worsen over weeks or months. Pain may intensify with movement or pressure on the elbow. Some individuals experience morning stiffness, muscle weakness, and persistent aching, making it difficult to perform everyday tasks. Pain may also occur even when the arm is at rest.
Diagnosis
To diagnose Tennis Elbow, a physician will conduct a physical examination and assess the patient’s medical and activity history. Simple tests will evaluate the forearm structures, and X-rays may be used to check for bone injuries or rule out other conditions like arthritis. While MRI scans are not commonly required, they can provide detailed images of tendon injuries if necessary. Both imaging methods are painless and require the patient to remain still.
Treatment
Most Tennis Elbow cases respond well to non-surgical treatments. Common recommendations include rest, modifying activities, and prescribed exercises often supervised by a therapist. Ice application and pain-relief medications can help alleviate symptoms. Wrist splints and forearm bands may also be beneficial for recovery.
Corticosteroid injections are another treatment option, providing safe pain relief directly at the elbow. Once pain is managed, physical or occupational therapy can help restore function by focusing on muscle strength, flexibility, and coordination, which has proven effective for many patients.
Surgery
Surgery for Tennis Elbow is rarely necessary, reserved for those who continue to experience significant pain after six months of treatment. This outpatient procedure can be performed under regional anesthesia or sedation. The surgeon makes a small incision on the outer elbow to remove damaged tissue and reattach the tendon. An arthroscopic approach, which uses a small camera to guide the procedure, is also available, minimizing incisions and reducing recovery time.
Post-surgery, the elbow is placed in a splint, with physical or occupational therapy starting after about a week to improve motion. Muscle strengthening exercises usually begin two months post-operation. Most individuals can return to their normal activities within four to six months, with favorable outcomes reported for the majority.
Recovery
Non-surgical treatment often alleviates Tennis Elbow symptoms within four to six weeks. However, some may experience chronic symptoms lasting several months. Those requiring corticosteroid injections or surgery may take longer to recover but typically achieve good results. With proper treatment, Tennis Elbow rarely leads to severe complications, and untreated cases seldom result in significant loss of motion or function.
