What Is a Tennis Elbow?
Tennis elbow or lateral epicondylitis is a painful condition of the elbow. It arises from the tedious stress of the extensor muscles and tendons during repetitive movements of the forearm and the wrist. These kinds of repetitive movements result in fatigue of the forearm, which leads to overloading of the tendon. This, in turn, causes pain and inflammation of the tendon called tendonitis. Further, it leads to a degenerative condition called tendinosis, which altogether results in tendon tearing.
What Is the Prevalence of Tennis Elbow?
One of the most typical causes of elbow pain is tennis elbow. According to experts, three percent of American adults suffer from tennis elbow annually. Over 90 percent of those diagnosed with tennis elbow do not sustain it from engaging in tennis or other sports, although the condition is named after the game. Men and women are equally affected and occurs in people aged between 35 and 54 years.
Who Is Prone to Get Tennis Elbow or Lateral Epicondylitis?
Despite its name, this condition is more commonly associated with work-related repetitive elbow and wrist movements like washing clothes, wringing clothes, hammering, and carpentry than in tennis players. It is seen in people who vigorously do repetitive actions that use the forearm, hands, or wrist. The following are the groups of people who are predisposed to tennis elbow:
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Fencers.
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Golfers.
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Baseball players.
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Squash players.
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Bowlers.
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Racquetball and pickleball players.
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Butchers.
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Manicurists.
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Chefs.
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Cleaners.
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Carpenters.
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Musicians.
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Gardeners.
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Plumbers.
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Auto mechanics.
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Assembly line workers.
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Individuals who regularly elevate over 45 pounds (22 kg).
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Those who are above 40 years old.
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Those who have the habit of smoking.
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Obesity.
What Are the Symptoms of Tennis Elbow or Lateral Epicondylitis?
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Burning sensation or pain in the outer elbow, which radiates to the wrist.
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Twisting or bending the arm causes pain.
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Weakening of grip.
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Pain and stiffness during arm extension.
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Swollen and tender elbow joint.
How Is Lateral Epicondylitis or Tennis Elbow Diagnosed?
Tennis elbow can be diagnosed by a medical professional through a physical examination and certain tests. They will assess the damage to the elbow and inquire about the signs. Inform the physician about any activities that make the discomfort, firmness, or other symptoms more severe. The physician may also instruct to take some tests which include the following.
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An Elbow X-Ray - A medical procedure that creates a picture of the internal structure of the elbow. The black-and-white image shows the anatomy or internal structure of the elbow.
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Electromyography - An electrode-equipped tiny needle is inserted into the muscle by a medical professional during electromyography to record the electrical activity of that muscle.
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Imaging Tests - Imaging tests like ultrasound, computed tomography, and magnetic resonance imaging detect damage in the muscles and nerves.
How Is Tennis Elbow or Lateral Epicondylitis Treated?
In its early stages, the condition responds well to rest, ice packs, analgesics, and anti-inflammatory drugs. However, later stages usually require intervention in the form of steroid injection and then surgical treatment.
1. RICE Method:
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Rest: Giving adequate rest to the tendons aids in healing.
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Ice: Several times a day, use an ice pack or cold compress on the elbow for up to 20 minutes at a time. Ice packs should be wrapped in a towel or other thin cloth to prevent direct skin contact.
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Compression: Place a bandage surrounding the elbow to provide compression. Individuals can learn to wrap the bandage from a physician.
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Elevation: Keep the elbow raised above the level of the heart.
2. Medications: Non-steroidal anti-inflammatory drugs like Naproxen and Ibuprofen help in reducing the pain and inflammation associated with lateral epicondylitis.
3. Steroid Injections: Corticosteroids are injected into the site of pain, which helps in relieving pain and inflammation. Ultrasound-guided steroid injections are given to a few individuals to determine the exact location of the injection site.
4. Braces: A counterforce brace can be worn to relieve the tension exerted on the muscles and tendons.
5. Physical Therapy: Physiotherapy exercises help in strengthening the muscles of the forearm and help in enhancing the grip. Ultrasound, massage, and muscle-stimulation techniques help reduce pain and inflammation and improve function.
6. Extracorporeal Shock Wave Therapy: With the help of this therapy, the scar tissue is broken down, leading to improved blood flow to the area of damage.
7. Platelet-Rich Plasma Therapy: In this therapy, a small amount of blood is taken with the help of PRP injection, platelets are removed, and the concentrated platelets are injected with the help of an ultrasound.
8. Minimally Invasive Tenotomy: This is a minimally invasive procedure in which the degenerative tendon tissue is hydro-resected with the help of a needle device.
If the non-surgical therapies do not help, arthroscopic surgery, tendon repair, or tendon debridement is recommended. It takes around four to six months to recover from surgery.
9. Duloxetine - The use of Duloxetine, a selective serotonin and norepinephrine reuptake inhibitor in chronic refractory elbow pain, which does not respond to any other non-surgical and surgical therapies, is under study.
How Is the Prognosis of Lateral Epicondylitis?
Lateral epicondylitis is usually treated by non-surgical therapies in about 95 percent of people, and the symptoms typically subside in a period of six to 18 months. However, few might require surgery. After surgery, recovery of symptoms usually occurs in one year.
How Can We Prevent Lateral Epicondylitis or Tennis Elbow?
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Warm up before starting work by stretching wrists and arms.
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Wear elbow braces.
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Do not push hard with pain.
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Strengthen wrist and forearm muscles by lifting weights.
At times, certain unusual conditions of the lateral aspect of the elbow can mimic or co-exist with a tennis elbow and can cause refractory pain.
Conclusion:
In certain cases, such as when one's occupation is the cause of the tennis elbow, it can be difficult to prevent. Keeping the muscles around the elbow from being overworked will help keep the illness from becoming more serious. Modifying the approach may help alleviate tennis elbow if it is a result of playing tennis or any other activity that repeatedly strains the elbow joint. Although surgery may be necessary in rare cases, physical therapy is typically used to treat it.
