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Tennis Elbow
Dr Kau Chung Yuan (许医生)
MBBS (S’PORE)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
What is Tennis Elbow?
Tennis elbow, scientifically known as lateral epicondylitis, is a condition characterised by pain and tenderness on the outside of the elbow. This discomfort is due to the overuse and strain of the tendons in the forearm, leading to inflammation and micro-tears where the tendons attach to the lateral epicondyle of the elbow.
Despite its name, tennis elbow is not confined to tennis players. It can occur in anyone who engages in activities that involve repetitive wrist and forearm motions.
Causes of Tennis Elbow
Key activities and factors contributing to the development of tennis elbow include:
- Repetitive Motions
Activities that involve repetitive wrist and forearm use, such as tennis, other racquet sports, painting, carpentry, and typing, can predispose people to tennis elbow. - Age and Occupation
The risk of developing tennis elbow increases with age. Occupations that involve repetitive and forceful use of the wrist and forearm are also at higher risk. - Improper Technique
Using incorrect techniques during sports or work activities can stress the forearm tendons more. - Excessive Force
Activities that require forceful forearm motions or gripping, such as lifting heavy objects or using tools, can lead to tendon strain.
Symptoms and Diagnosis
Symptoms
People with tennis elbow often experience:
- Pain and Tenderness
Located on the outside of the elbow and may extend into the forearm and wrist. - Weakness
Grip strength may decrease, making it difficult to hold objects. - Stiffness
The elbow may feel stiff, especially in the morning or after periods of inactivity. - Pain with Activities
Extending the wrist or gripping can worsen the pain.
Diagnosis
The diagnosis of tennis elbow typically involves a detailed clinical history and physical examination. Imaging tests may be used to confirm the diagnosis and rule out other conditions that could cause similar symptoms.
Magnetic Resonance Imaging (MRI) and ultrasound can help visualise soft tissue changes, confirm the diagnosis in uncertain cases, or guide certain treatments. These diagnostic tools ensure an accurate diagnosis of tennis elbow and the development of an effective treatment plan.
Non-surgical Treatment
The majority of tennis elbow cases respond well to non-surgical treatment methods, which aim to relieve pain and restore normal function to the arm:
Rest And Ice
Limiting activities that aggravate the condition and applying ice packs can help reduce pain and swelling.
Bracing
A brace or strap around the forearm can reduce stress on the injured tendons.
Physical Therapy
Specific exercises can strengthen forearm muscles and improve flexibility.
Medications
Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation.
Corticosteroid Injections
These may be considered for short-term pain relief in severe cases.
Surgical Treatment
Surgery may be considered for patients whose symptoms do not improve with non-surgical treatments after a period of six to twelve months. Surgical options include:
- Open Surgery
The most common procedure involves making an incision over the elbow, removing diseased muscle and reattaching the healthy muscle to the bone. - Arthroscopic Surgery
A minimally invasive technique using small instruments and incisions to remove damaged tissue from the tendon.
Complications of Tennis Elbow
While effective treatment and proper rehabilitation can lead to a full recovery from tennis elbow, some people may experience complications, including:
Persistent Pain
A minority of patients continue to experience chronic elbow pain despite treatment.
Elbow Stiffness and Reduced Mobility
Long-term stiffness and decreased range of motion in the elbow joint can occur, particularly if the condition is severe or not adequately treated.
Recurrence
There is a risk of tennis elbow symptoms recurring, especially if the initial cause of the condition, such as repetitive strain or improper technique, is not addressed.
Surgical Complications
Although rare, surgery for tennis elbow can lead to complications such as infection, nerve damage, or incomplete relief of symptoms.
Dr. Kau Chung Yuan
MBBS (S’pore)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
- Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
- Master of Medicine (Orthopaedics), Singapore (MMed) 2013
- Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
- Bachelor of Medicine and Surgery (MBBS, Singapore) 2004
Prevention Tips
Preventing tennis elbow involves measures that reduce the strain on the forearm muscles and tendons. Here are some effective strategies:
- Proper Technique: Learning and using the correct technique for sports and other activities can help minimise stress on the elbow and forearm.
- Equipment Adjustment: Using equipment that suits one’s body size and strength, such as lighter sports racquets or ergonomic tools, can also reduce the risk.
- Strength and Flexibility Exercises: Regular exercises that strengthen the forearm muscles and improve wrist and arm flexibility can help prevent tennis elbow.
- Taking Breaks: Incorporating regular breaks into activities that involve repetitive arm movements can prevent overuse.
- Gradual Increase in Activity: Gradually increasing the intensity and duration of activities can help the muscles and tendons adapt without becoming overstressed.
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Sunday: Closed
Frequently Asked Questions (FAQs)
Can tennis elbow occur in both arms simultaneously?
While tennis elbow typically affects one arm, symptoms can occur in both arms simultaneously, especially if one engages in activities that strain both sides equally.
Can specific forearm exercises eliminate the need for surgery in tennis elbow cases?
While specific forearm strengthening and stretching exercises can help in recovery and prevention, they may not permanently eliminate the need for surgery in severe cases. However, consistent rehabilitation exercises can significantly reduce symptoms and improve function, potentially avoiding surgery.
How does tennis elbow differ from golfer's elbow?
Tennis elbow, or lateral epicondylitis, affects the outer elbow and is caused by overuse of the forearm’s extensor muscles. Golfer’s elbow, or medial epicondylitis, affects the inner elbow and involves the forearm’s flexor muscles. Both conditions are overuse injuries, but they involve different tendons and muscles.
Is acupuncture an effective treatment for tennis elbow?
Acupuncture may reduce pain and inflammation in some individuals with tennis elbow, providing relief. While evidence of its effectiveness is mixed, it can be considered a complementary treatment option alongside more conventional therapies.