Tennis Elbow
Overview
Tennis elbow, which is also known as lateral epicondylosis is a condition associated with overloading of tendons in your elbow, which is usually caused due to repetitive motion of arm and wrist. By the name of the condition, tennis players may be susceptible, but most cases occur in those without a history of racquet use.
Symptoms
Pain originates from the outer part of your elbow into your forearm and wrist. You are bound to develop a weak grip strength. As a result, both of these factors make it difficult to undergo the following activities-
- Lifting something
- Gripping an object like a racquet or a coffee mug
- Turning a doorknob
- Straightening your wrist
Risk Factors
Factors which contribute towards an increased risk of tennis elbow are-
- Age: Even though tennis elbow is a condition which can happen to anyone, it is most commonly witnessed in people within the age group of 40-55 years.
- Occupation: Tennis elbow is most commonly seen in people whose job include continuous weight lifting or repetitive movement of arm and wrist. Some of these occupations include, plumbers, painters, carpenters and cooks.
- Various sports: Indulging in sports like tennis involves continuous movement of wrist and arm. The chances of having tennis elbow is most common in athletes with a poor stroke technique.
Clinical Features
The patient is usually an active persona aged between 40 to 55 years. Lateral elbow pain comes on gradually, often after a period of unaccustomed activity. Usually, radiation down the forearm and elbow stiffness are first thing experienced in the morning. The elbow usually looks normal but slight swelling may be visible. The patient will typically have a full range of movement.
Tenderness is triggered by palpation over the front of the lateral epicondyle and by provocative manoeuvres such as resisted middle finger extension (maudsley’s test) or elbow extension in pronation with a flexed wrist (mill’s sign).
Treatment
The natural history of tennis elbow is for spontaneous resolution within 12 months in 90% of cases. The condition can be treated in both, an operative and a non-operative way.
Non-Operative Treatment
- Activity modification and physiotherapy will speed up recovery. This means identification and avoidance of precipitating factors, and an eccentric loading regime for the common wrist extensors.
- A static wrist splint may help in relieving pain.
- Steroid injection will provide short term pain relief but recurrence rates are high and the elbow is more likely to be painful in the long term. Autologous blood product injection may even play a role.
Operative Treatment
If the pain persists despite adequate non-surgical measures, tendon debridement can provide pain relief (it has proven to do so in 85% of cases). Surgery can be performed as an open procedure with an average of 6 weeks recovery, or using arthroscopic technique with a faster recovery of 2 weeks but a higher risk of nerve injury.