What is Tennis Elbow?

Tennis elbow (also known as lateral epicondylitis or elbow tendonitis) is the most common elbow injury in Australia which affects up to 7 in 1000 people [1] or roughly 180,000 individuals. This condition is a painful elbow condition which can gradually develop if not managed appropriately. Having tennis elbow can severely impact your ability to perform normal daily activities, such as performing at-home or work-related duties. One of the key challenges of tennis elbow is preventing chronic pain which can persist for weeks and years.

Tennis Elbow Symptoms

Symptoms of tennis elbow usually start mild but can quickly develop into more irritating symptoms. Examples of common symptoms reported by patients include:

Outer elbow pain which can spread down the backside of the forearm.
Pain which aggravated through repetitive wrist movement, gripping and lifting
Weakness when gripping or using the affected hand, wrist and/or elbow.

How does tennis elbow start?

Tennis elbow usually presents as an overuse injury. Contrary to popular belief, most people diagnosed with tennis elbow do not play tennis [2]. Activities that involve constant and repetitive forearm movement are typically responsible for the onset of tennis elbow. As a result, the symptoms of tennis elbow slowly build up over time because of the increasing strain on the forearm. Due to the constant strain on the forearm muscles (especially the extensor carpi radialis brevis), structural changes can begin to occur at the elbow. These changes lead to inflammation, microscopic tears and tissue breakdown of the tendon which connects these muscles to the elbow joint.

Tennis Elbow Causes

Tennis elbow is usually caused by repetitive and constant wrist activities. Examples of these common aggravating activities, include [3]:

Office work (e.g. typing, using the mouse, etc.)
Manual labour, particularly with duties that require excessive gripping, carrying and dealing with vibrating tools (e.g. jackhammers, drills, etc.)
Using hand tools (e.g. clippers, screwdrivers, spanners, etc.)
Racquet sports
Activities which require repetitive elbow bending (e.g. violin, weightlifting, etc.)
Knocking the outside of the elbow

Tennis Elbow Tests and Diagnosis

Generally, tennis elbow can be diagnosed through a thorough medical screening and physical examination. Special physical tests can be performed by GPs to help diagnose tennis elbow. Although imaging is not required, some GPs may refer for further investigations, such as ultrasound or less commonly an MRI.

Tennis Elbow Treatment

Tennis elbow can be particularly difficult to treat, especially for those who work in particularly arm dominant activities. GPs play an essential role in helping you manage your pain and directing you to other health services. One or several of the treatments could be recommended by your GP depending on your unique circumstances.

Physiotherapy

GPs commonly refer patients with tennis elbow to physiotherapy. Physiotherapists will use a range of strategies and treatments to assist with recovery from tennis elbow. Examples include [5]:

Tennis elbow exercises to strengthen the forearm muscles and tendon.
Modifying day-to-day activities to offset stress from the elbow.
Manual therapy to provide short-term pain relief (e.g. soft tissue massage, joint mobilisations, etc.).
Dry needling and/or electrotherapy to assist with pain relief and muscle tension

Medication

GPs may recommend taking medications during the earlier stages of your tennis elbow. Pain relief medications, such as non-steroidal anti-inflammatories (NSAIDs) and topical glyceryl trinitrates [1] are commonly prescribed to provide short-term pain relief.

Tennis elbow brace or strap

A tennis elbow strap or brace can be worn to distribute the stress away from the injured tissue to other regions. Especially when performing activities that could be aggravating, braces and straps can provide some relief. Most local pharmacists or health stores should supply braces and straps for purchase.

Surgery

If symptoms continue to persist and reduce quality of life, GPs may suggest a referral to a surgeon. Whilst very rare, some tennis elbows may need surgery to fix the damage which has occurred to the tendon.

Other Treatments

Sometimes, GPs may also refer for other treatments that may help with pain relief and progress. Although the research for these treatments are not robust, patients have reported benefits.

Acupuncture
Corticosteroid injections
Laser therapy
Shockwave therapy
PRP injections

Tennis Elbow Recovery

Recovery from tennis elbow can vary person to person. However, the majority of sufferers will have positive outcomes. Most people will find that their tennis elbow will have recovered between 6-24 months. In fact, approximately 90% of people will overcome their symptoms within 12 months [1]. Generally, the earlier treatment is sought, the faster the recovery. Adherence to the treatments, such as using the brace and exercise may assist can be beneficial.

Complications

Overall, most of those with tennis elbow will recover. However, there is a small population which may experience long-term elbow pain and disability. GPs may refer for different treatments if conventional ones have not worked. While steroid injections can help provide some relief, multiple doses may weaken the tendon. Poor tendon health can lead to additional tearing and even rupture of the tendon. Other complications that may occur, include [4]:

Misdiagnosis
Persistent elbow pain which requires surgery
Bone spurring
Local nerve compression and damage

Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.

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