Information From Your Health Care Provider

TENNIS ELBOW

(Epicondylitis, Lateral)

Basic information

description

Tennis elbow is an inflammation of the tendons on the outside of the elbow at the epicondyle. The epicondyle is the bony area on the outside of the elbow. This is where muscles of the forearm attach to the bone of the upper arm.

FREQUENT SIGNS & SYMPTOMS

Pain and tenderness over the bony part of the elbow.
Unable to straighten the arm completely.
Stiffness in elbow in the morning.
Pain when bending or twisting the hand and arm.
Weak grip (even when grabbing a light object such as a coffee cup).

causes

The tendon becomes inflamed due to a variety of reasons. Most often, it is a result of overuse or repetition. Small tears in the tendon may lead to the problem. Inflammation is a reaction of the body's tissues to injury, infection, or irritation. The four signs of inflammation are redness, swelling, heat, and pain.

risk increases with

Work or activity that requires repetitive forearm movement (e.g., hedge clipping, racket sports, or golf).
Work or activity that requires excessive, constant gripping or squeezing.
Poor physical condition.
Sudden strain on the forearm.

PREVENTIVE MEASURES

Don't play sports, such as tennis, for long periods until you are in good condition. Learn proper playing techniques. Tennis racquets can aggravate tennis elbow. Choosing a different size or type (larger, more flexible, larger grip) may help.
For work or sports activity requiring elbow movement, warm up the arm for 5 to 10 minutes. Take frequent breaks. Use ice pack on elbow if pain develops.
Do flexibility and strength exercises for the arm and elbow.

expected outcomes

Usually curable, but it takes time. Healing may require 3 to 6 months or longer.

possible complications

Recurrence of tennis elbow.
Rarely, surgery may be needed for some patients.

diagnosis & treatment

general measures

Mild cases may be self-treated if desired.
See your health care provider if symptoms persist or are more severe. A physical exam of the affected area will be done and questions asked about your symptoms and activities. X-rays do not show tendon problems, but they may be done if an injury occurred.
Treatment may involve rest, ice or heat, massage, drugs, exercises, and steps to prevent recurrence.
When resting, sleeping, or sitting, place the injured area on a pillow—at or above heart level.
Wrap the thickest portion of the forearm in a compressive (Ace) bandage to reduce swelling. Massage the area several times a day.
Apply ice packs to the affected area (several times a day) for the first 24 to 48 hours. Then apply heat if it feels good. Take hot showers, soak in a bath, apply hot compresses, or a heating pad.
You may need to wear a forearm brace or splint to immobilize the elbow. Do the following exercise 3 or 4 times a day while wearing the splint. Stretch your arm, flex your wrist, and then press the back of your hand against a wall. Hold for 1 minute.
Surgery possibly (if other methods of treatment fail).

medications

Use nonprescription nonsteroidal anti-inflammatory drugs and pain relievers such as ibuprofen or aspirin (not for children).
Steroid injection for painful tendons may be recommended. This reduces pain and inflammation and allows movement. Injections are done just a few times as steroids can weaken the tendon.

activity

Don't repeat the activity that caused tennis elbow until symptoms clear up. Stretching and strength exercises are often prescribed to do at home. Do them daily or as directed.
Physical therapy may be prescribed.