Lateral epicondylitis is commonly known as tennis elbow. Tennis elbow is described as the tendons that extend the wrist becoming swollen and inflamed.
Tennis elbow is a condition that is commonly diagnosed in both men and women aged between 30 to 50 years old, however it can also affect other people depending on a number of factors.
Definition
Lateral epicondylitis is the most common cause of elbow pain, mainly resulting from repetitive gripping or wrist extension during activities. It is basically a result of degeneration of the local tendon at the elbow.
Tennis elbow is commonly associated with repetitive microtrauma. As mentioned above, this may be from a result of excessive gripping, wrist extension, radial deviation, and forearm supination. The extensor carpi radialis brevis (ECRB) is the most frequently affected muscle.
Although it was originally thought to be an inflammatory condition, histopathological studies have shown that there is an absence of inflammatory cells, and it is thought to be more due to a tendinosis, which is a degenerative process. Repeated strain on the tendon causes collagen deposition and proliferation of fibrous tissue which become vulnerable to repetitive forces and then results in further tears.
It mainly affects middle-aged people, and it is almost always curable.
Causes
Tennis elbow is considered an injury caused by overuse or a muscle strain. The common cause is repeated contraction of the forearm extensor muscles, which are the muscles used to straighten and raise wrist and hand. Repeated stress to these tissues results in a series of microtears in the tendons that attach the forearm muscles to the bone along the outside of the elbow.
This condition was given its name, due to its association with those playing tennis and experiencing pain from the repeated use of the backhand stroke. However, this condition is also a result of other repetitive activities, such as:
- Using hand and power tools
- Digging holes and using a shovel
- Using a paint brush or roller
- Using a drill
- Cutting up food – such a meat, using a butcher’s knife
- Repetitive computer and mouse use
- Repetitive hand motions in particular jobs, such as gardeners, musicians, labourers, dentists, carpenters and administration workers.
Signs & Symptoms
The symptoms of tennis elbow usually develop gradually, and in most cases, pain begins as a mild ache and slowly worsens over time. There is usually no specific event or injury associated with the onset of symptoms.
Common symptoms of tennis elbow include:
- Pain or burning that may radiate from the outer part of the elbow, down to the forearm and wrist.
- Reduced grip strength
- Night pain
- Pain with gripping
- Pain with activities such as shaking hands, holding a racquet, holding tools, typing or using a mouse
- Although this problem can occur in both arms, the dominant arm is usually affected.
Diagnosis & Treatment
In most cases, tennis elbow can be diagnosed during a physical examination. This involves history taking, palpation and some specific tests such as the Cozen’s test and the Mill’s test.
Ultrasound is an efficient, non-invasive, and relatively cost-effective imaging method that can also be used to confirm the diagnosis if needed.
In most cases, tennis elbow is treated conservatively and can often take several months to treat due to the chronic nature of the condition. There are several ways to treat tennis elbow including task modification, splinting and counterforce braces, hand therapy, cortisone injection, strengthening and in some cases, surgery.
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Prevention
- Tennis elbow is often stubborn to treat, but generally always gets better with rest and task modification.
- Some exercises can help to reduce pain more quickly and improve the strength and use of your arm.
- Keep being active but try to avoid activities that increase pain.
- Activity and task modification – Avoid activities that involve repetitive movements, moderation with such activities, changing your style of grip or duration of activities.
Melbourne Hand Therapy Can Help You
There are several treatments that may help reduce the intensity of your symptoms and relieve the pain and loss of function. Nonsurgical treatment options may include splinting, exercises and education on activity modification. Your hand therapist can assist you with these interventions.
If you are experiencing any of these symptoms, book an appointment.
