TENNIS ELBOW

General Information

DEFINITION--Inflammation of bony areas of the elbow.

BODY PARTS INVOLVED--Elbow muscles, tendons and epicondyle (a bony prominence on the outside of the elbow where muscles of the forearm attach to the bone of the upper arm).

SEX OR AGE MOST AFFECTED--Adults (20 to 40 years).

SIGNS & SYMPTOMS

• Pain and tenderness over the epicondyle.
• Weak grip.
• Pain when twisting the hand and arm, as in using a screwdriver or playing tennis.

CAUSES--

Partial tear of the tendon and attached covering of the bone caused by:

• Chronic stress on the tissues that attach the forearm muscles to the elbow area.
• Sudden strain on the forearm.

RISK INCREASES WITH

• Occupations that require strenuous or repetitive forearm movement, such as mechanics or carpentry.
• Participation in sports that require strenuous or repetitive forearm movement, such as tennis.
• Poor physical conditioning.

HOW TO PREVENT

• Don't play sports, such as tennis, for long periods until you are in excellent condition. Take frequent rest periods.
• Tennis racquets can aggravate tennis elbow. Choosing a different size or type (larger, more flexible, larger grip) may help.
• Get professional help if you are just learning tennis. Technique and conditioning are important in preventing injuries.
• Do forearm conditioning exercises to build your strength gradually.
• Warm up slowly and completely before participating in sports, especially before competition.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Diagnostic tests are usually not necessary (x-rays are usually always negative).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis. Treatment normally consists of medications and supportive care.
• Doctor's treatment.
• Physical therapy.
• If other methods of treatment fail, surgical release of the tendon at the epicondyle may be necessary.

POSSIBLE COMPLICATIONS--Complete ligament tear, requiring surgery to repair.

PROBABLE OUTCOME--Usually curable, but treatment may require 3 to 6 months.

How To Treat

GENERAL MEASURES--

• Use heat or ice to relieve pain. Use warm soaks, a heat lamp or soak in a whirlpool or use cold compresses or ice packs (whichever seems to help the most).
• You may receive diathermy, ultrasound or massage treatments. These help bring quicker symptom relief and healing.
• Massage therapy and manipulation.
• You may need to wear a forearm splint to immobilize the elbow. Do the following exercise 3 or 4 times a day while wearing the splint: Stretch your arm, flex your wrist, then press the back of your hand against a wall. Hold for 1 minute.
• Consider using a tennis-elbow strap when you resume normal activity after treatment.

MEDICATION--S--Your doctor may prescribe:

• Nonsteroidal anti-inflammatory drugs to reduce inflammation.
• Injections of anesthetics or cortisone drugs. Cortisone reduces inflammation and anesthetics temporarily relieve pain. Caution: Repeated injections may weaken the muscle ligament.

ACTIVITY--Don't repeat the activity that caused tennis elbow until symptoms disappear. Then resume your normal activities gradually after proper conditioning.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of tennis elbow.
• Symptoms don't improve in 2 weeks, despite treatment.