Tennis elbow is a common condition that occurs on the outside of the elbow joint. It occurs over the bone of the distal humerus, called the lateral epicondyle. A professional name for tennis elbow is lateral eqicondylitis.
Tennis elbow is more common than people believe and is a nagging injury that is slow to heal. In severe cases, it requires treatment with a physical therapist, other medical professionals, and oftentimes, a surgeon.
While bearing the name of our favorite sport, it is not always caused by playing tennis. Other causes can contribute to tennis elbow, such as lifting weights, a heavy briefcase, using hammers, twisting a screwdriver, opening jars or anything that involves a power grip.
Typically, the muscles that extend the wrist to enable one to have a stronger grasp and increase strength in their hand originate off the lateral elbow and can tear with a very strong use of the hand.
Tennis elbow can be chronically painful and can last for an extended period of time. It is a degenerative process where the tendon gradually breaks down and then will suddenly tear. Scar tissue forms and as it is beginning to heal and get stronger, the person will do a physical activity with his hand that involves a forceful grip and the muscle tears again. Each time it tears, the scar tissue increases and healing slows.
Tennis elbow is diagnosed by a clinical exam. The pain may originate in the elbow, but travel down the arm. Typically, it is isolated to that bone and into the proximal portion of the muscles where they originate off the bone. The pain can be intense and give the sensation of a “dead arm” with forceful contraction of the muscles in the hand.
Typically, the easiest form of treatment for tennis elbow is the use of non-steroidal anti-inflammatory medications. When participating in physical activity, it is beneficial to warm up slowly and to ice afterwards. A tennis elbow brace can also be very useful. This is a strap that wraps around the arm just below of distal to the torn tendon. This allows function without further aggravation. In severe cases, a cortisone shot may be required. Surgical intervention is required in only approximately 3% of cases.
Alternative forms of treatment include an ultrasound, friction massage, cortisone shots, and an injection of platelet enriched plasma (a relatively new treatment), all of which can reduce inflammation. All of these modalities make therapy more effective.