Other Names

Lateral epicondylitis, Epitrochlear bursitis, Elbow inflammation

What is Tennis Elbow?

Tennis elbow or lateral epicondylitis is an injury to the muscles and ligaments, which attach to the outside of the elbow (lateral epicondyle).

Causes, Incidence and Risk factors

The most common cause of tennis elbow is injury to the muscles (usually the extensor carpi radialis brevis ECRB). These muscles are responsible for the extending and rotating the wrist.

Studies reveal that 50% of tennis players suffer from this orthopedic condition. However, it is common in people engaged in any activity that involves overuse of this particular muscle.

Factors such as improper technique of playing, improper size of racquet handle, racquet weight, and faulty body mechanics may increase the risk of developing tennis elbow.

Signs and Symptoms

Symptoms include pain in the lateral elbow and the forearm, which increases with activity. Athletes and middle-aged people engaged in rigorous physical activity are particularly susceptible.

Pain accompanies even everyday activities like holding a cup or rotating a door knob.

Screening and Diagnosis

• Laboratory tests are of no particular use in this condition.
  
  
• X-ray studies are helpful to confirm diagnosis and rule out degenerative causes and other injuries.
  
  
• Radiographs demonstrate the presence of osteophytes on the affected joint.
  
  
• MRI is increasingly becoming popular in diagnosing lateral condylitis as it can show the presence of tendon disruption and injury.
  
  
• Diagnosis is confirmed if the corticosteroid injection in the affected muscle relieves pain.

Treatment

Conservative methods of treatment are the best option.

• Use the RICE (Rest, Ice, Compression, Elevation) fomula for treatment
• Medications (NSAIDs) are used to relieve the pain.
• Corticosteroid injections are also helpful.

R.I.C.E.:

Rest
Reduce or stop using the injured area for 48 hours. If you have a leg injury, you may need to stay off of it completely.

Ice
Put an ice pack on the injured area for 20 minutes at a time, 4 to 8 times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice that has been wrapped in a towel.

Compression
Compression of an injured ankle, knee, or wrist may help reduce the swelling. These include bandages such as elastic wraps, special boots, air casts and splints. Ask your doctor which one is best.

Elevation
Keep the injured area elevated above the level of the heart. Use a pillow to help elevate an injured limb.

Symptomatic relief is followed by a phase of rehabilitation, where the muscles are strengthened and toned so that normal activities can be resumed.

Surgery is done in patients who do not get any relief from non-invasive methods. Surgery involves debridement of the affected muscle and decortication of the epicondyle. After surgery the action of the wrist is restored in 3-4 days and the patient can resume his activities within 6 weeks. In case of athletes, they can start their sport related activities within 4-6months.

Prevention

Tennis elbow can be prevented by taking the following precautions:

• Strengthening exercises along with tennis training
• Proper size of equipment
• Proper techniques of play
• Proper body mechanics