Tennis elbow also called lateral epicondylitis, is a very common condition that results in pain on the outside of the elbow, which is aggravated by activity. Tennis elbow is tendonitis involving the muscles that bend the wrist backwards (extensor muscles). It involves inflammation or micro-tearing of the tendon. This may start spontaneously due to overuse or be caused by an injury. The tendon inserts onto the bone on the outside of the elbow, which is the site of maximum tenderness.
Tennis elbow can be caused by activities such as work or sports, which may require repetitive and vigorous use of the forearm muscles. It may also be caused by repetitive injuries. People who are 30 – 50 years of age are at highest risk of tennis elbow. Risk factors include playing sports like tennis, improper equipment and any activity that involves repetitive wrist movements.
The condition presents with tenderness around the bony prominence on the outside of the elbow, which is where the tendonitis is. There is also pain with the use of the hand and wrist, which often results in weakness as well, especially when gripping. Other symptoms may include pain or a burning sensation on the outer part of the elbow. Symptoms of tennis elbow develop gradually and often are made worse with repetitive forearm activity like turning a wrench, shaking hands or holding a racquet. Tennis elbow can affect both the arms, but the dominant arm is the one that is commonly affected.
Most cases of tennis elbow respond well to conservative management. This consists of rehabilitation involving stretching and eccentric muscle strengthening. Corticosteroid injections can speed up recovery. Bracing and dry needling can give relief as well. Those that do not get better with a course of conservative management may need surgery. This involves a small operation to remove the tendonitis, which is done as a day procedure.