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Tennis elbow: Treatment, symptoms, advice and help

About tennis elbow

Tennis elbow, also called lateral epicondylitis is a condition where the outer part of the elbow becomes sore and tender. It is commonly associated with playing tennis and other racquet sports, though the injury can happen to almost anybody. It is the most common cause of elbow pain excluding traumatic conditions.

Tennis elbow: Incidence, age and sex

The annual incidence of tennis elbow in general practice is 4-7 cases per 1,000 patients, with a peak in patients 35-54 years of age.

Signs and symptoms of tennis elbow: Diagnosis

The patient complains of pain around the lateral epicondyle and in the back of the forearm with certain activities. There is no history of trauma, but the patient may relate the onset to a period of strenuous activity. On examination, the patient is locally tender, near the lateral epicondyle. Forced flexion and pronation or resisted wrist extension against resistance reproduces the pain. The diagnosis is essentially a clinical one.

Causes and prevention of tennis elbow

The aetiology is unknown in the majority of cases, but the condition commonly follows a period of overactivity, particularly unaccustomed activity that involves active extension of the wrist. The tendon of the muscle extensor carpi radialis brevis may show a partial muscle tear and chronic inflammatory tissue. For prevention patients often have to modify their activities or the particular techniques that lead them to develop this overuse injury. This may need to include the help of a coach for sporting activities.

Tennis elbow: Complications

Left untreated, a tennis elbow can result in chronic pain — especially when lifting or gripping objects.

Tennis elbow: Treatment

Most cases are resolved without medical treatment, especially when the precipitating activity is avoided. Persistent cases may be treated with simple analgesia or a local injection of hydrocortisone, depending on severity, but repeated injections should be avoided. Other effective non-surgical measures include extensor mass stretching exercises and deep massage of the extensor mass, followed by cooling the elbow with ice packs. Open or arthroscopic surgery may be indicated occasionally, and local excision of the abnormal tissue will produce good results in 70 – 90% of the patients.