What is tennis elbow and the lateral epicondyle?

Tennis elbow, also known as lateral epicondylopathy, is a painful condition that occurs when the tendons that attach to the lateral epicondyle (a bony bump on the outer side of the elbow) become inflamed or damaged. Despite its name, tennis elbow can occur in anyone who performs repetitive activities that involve gripping or twisting motions of the wrist and forearm, such as typing, using a mouse, or playing musical instruments.

What are the symptoms of tennis elbow?

The symptoms of tennis elbow include pain and tenderness on the outer side of the elbow, particularly when gripping, twisting, or lifting objects. There may also be weakness and limited range of motion in the affected arm. The pain may be felt both during activity and at rest, and can sometimes radiate down the forearm.

What causes tennis elbow?

When you perform the same motion repeatedly, such as swinging a tennis racket or hammering a nail, the muscles and tendons in your forearm can become strained and damaged. This can cause inflammation and tiny tears in the tendons that attach to the lateral epicondyle, which is the bony bump on the outer part of your elbow.

How is tennis elbow diagnosed?

Diagnosing tennis elbow typically involves a physical exam and a discussion of your symptoms and medical history with a healthcare provider, such as a doctor or a physiotherapist.

During the physical exam, we will usually press on the outer part of your elbow to check for pain and tenderness. We may also ask you to perform certain movements or activities that can worsen your symptoms, such as lifting a heavy object (like a weight), or turning a doorknob.

In some cases, imaging tests such as X-rays or MRI scans may be used to rule out other conditions that can cause similar symptoms, such as a fracture or arthritis.

It's important to note that while tennis elbow can usually be diagnosed based on a physical exam and medical history, it's always a good idea to seek professional medical advice if you're experiencing elbow pain or discomfort that's interfering with your daily activities. Early diagnosis and treatment can help prevent further damage and improve your chances of a full recovery

How is tennis elbow treated?

Treatment for tennis elbow usually involves resting the affected arm, applying ice to reduce inflammation, and doing exercises to stretch and strengthen the forearm muscles. In more severe cases, a doctor may recommend physical therapy, medication, or even surgery.

There are several treatment options available for tennis elbow, depending on the severity of the condition. Here are some common approaches:

• Rest: One of the first steps in treating tennis elbow is to rest the affected arm and avoid any activities that worsen your symptoms

• Ice: Applying ice to the affected area can help reduce pain and inflammation. You can use a cold pack or a bag of ice wrapped in a towel for 15-20 minutes at a time, several times a day.

• Physical therapy: A physio can teach you exercises to stretch and strengthen the forearm muscles and improve your grip strength. They may also use techniques such as massage or ultrasound therapy to help reduce pain and inflammation.

• Medications: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help relieve pain and reduce inflammation.

• Brace or splint: Wearing a brace or splint around the forearm can help reduce strain on the affected tendons and promote healing.

• Steroid injections: In some cases, a healthcare provider may recommend a corticosteroid injection to help reduce inflammation and pain.

• Surgery: In rare cases where other treatments have been ineffective, surgery may be recommended to repair or remove damaged tissue.

It's important to work with a healthcare provider to determine the best treatment approach for your specific situation. With proper treatment, most people with tennis elbow can recover and return to their normal activities.

Do I need to get any imaging done?

Imaging findings for tennis elbow may include thickening and irregularity of the common extensor tendon on ultrasound or MRI, and sometimes even calcifications at the tendon's attachment site.

Treatment options for tennis elbow include rest and avoiding activities that exacerbate the pain, ice therapy, nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation, and physical therapy to improve strength and flexibility. In severe cases, corticosteroid injections may be used to reduce inflammation and pain.

Exercise plays a crucial role in the management of tennis elbow. Strengthening exercises for the wrist extensors, forearm muscles, and shoulder stabilizers can help improve overall upper limb function and reduce the strain on the affected elbow. Stretching and soft tissue mobilization techniques can also help reduce pain and improve flexibility.

Injections may also be used in the treatment of tennis elbow. Corticosteroid injections can provide short-term relief of pain and inflammation, but repeated injections may have negative effects on tissue health and function. Platelet-rich plasma (PRP) injections, which use the patient's own blood to promote healing, may also be considered as an alternative to corticosteroid injections.

If you suspect you have tennis elbow, it is important to seek medical attention from a qualified healthcare provider. With proper diagnosis and management, most people with tennis elbow can recover fully and return to their normal activities.

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