Tennis elbow or ‘Lateral epicondylitis’ is a condition of persistent pain on the outer side of the elbow.It is caused by an overuse of forearm muscles resulting in repetitive injury to the tendons attached to the elbow.It can become responsible for substantial pain and loss of function of the affected limb.As the name may confuse,it is not only associated with the sport ‘Tennis’.It can be due to any other sport or work related activities.
The extensor muscle called the extensor carpi radialis brevis, helps to straighten and stabilize the wrist.This muscle attaches to a part of the elbow bone called the lateral epicondyle (thus the medical name ‘lateral epicondylitis’). It is the tendons that connect and transmit a muscle’s force to the bone. In lateral epicondylitis, tendon’s attachment to the bone is degenerated due to repetitive use, weakening and placing greater stress on the forearm muscles. This can lead to pain associated with activities in which this muscle is active.
Here are some potential causes of this condition:
- Overuse: This can be both non-work and work-related. Overuse can happen from “repetitive” gripping and grasping activities such as cutting, plumbing,gardening,carpentry, painting, etc.
- Trauma: Although less common, a direct blow to the elbow may result in swelling of the tendon that can lead to degeneration. This can make the elbow more susceptible to an overuse injury.
Who is affected?
Tennis elbow is most commonly seen in following groups of people:
- Manual Laborers
People who work with their hands like plumbers or bricklayers are at greater risk of developing tennis elbow.
- Sports Participants
Sports participants, especially racquet sport players and throwing sports persons(discus and javelin),are prone to developing tennis elbow.
- People doing activities that involve fine, repetitive hand and wrist movements – such as using scissors or typing
It is present in 40% of all racquet sport players and 15% of people working in repetitive manual trades like . It can occur at any age, however, sufferers are generally between the ages of 35 and 50.Predictably, the side affected is usually associated with handedness, but it can occur in the non-dominant arm. Males and Females are affected equally.
The typical symptom is pain in outer side of elbow,the area also becomes tender.But the pain can radiate into forearm and wrist also.
- Pain when performing gripping tasks or resisted wrist/finger extension
- Pain when the muscles are stretched.
- Tenderness directly over the bony epicondyle
There may be rigger points in the wrist muscles.In severe cases, there may be local swelling .Also some activities, such as making a fist, shaking hands, carrying bags like a briefcase, turning on taps may be painful.Some sufferers will also have neck stiffness and tenderness, as well as signs of nerve irritation.
Diagnosis and treatment
Usually, doctors are able to make the diagnosis based on the history and a physical examination.Additional tests such as X-rays or ultrasound may be needed to exclude other causes and/or assess the severity of tendon damage.
Initial treatment involves relative rest and avoiding activities that aggravate the pain.If you are diagnosed with tennis elbow, activities that strain affected muscles and tendons should be immediately stopped.Taking analgesics may help ease mild pain and inflammation caused by tennis elbow.. Wearing a tennis elbow brace can help to protect the tendon.
Physiotherapy has been shown to be effective in the short and long-term management of tennis elbow.Physiotherapy treatment can include gentle mobilisation of your neck and elbow joints, electrotherapy, elbow kinesio taping, muscle stretches, neural mobilisations, massage and strengthening.
A small percentage of patients diagnosed with tennis elbow may finally require surgical treatment. Patients may consider surgery if conservative treatments are not effective after a period of 6 – 12 months.
Untreated Tennis Elbows can last anywhere from 6 months to 2 years. You are also prone to recurrence.Aside from pain, the major complication of tennis elbow is that it impedes your ability to perform physical activities, such as certain sports or types of work.
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