Lateral epicondylitis or tennis elbow was first described in 1883 by Major as a condition that was causes lateral elbow pain in tennis players, hence the name tennis elbow. However it has been extended throughout the years to be synonymous with all lateral elbow pain, even with patients who do not play tennis at all and this condition is generally work-related. The biomechanics of this condition generally are from overuse or specific activities that cause stress to the extensor carpi radialis brevis (ECRB) muscle. In tennis players, it was demonstrated that the eccentric contractions of the ECRB during backhand tennis swings can be the cause of the repetitive microtrauma that causes microtears in the ECRB tendon attachment to the lateral epicondyle and subsequently tennis elbow. In the non-tennis population is is generally people who work or participate in activities that require repetitive and vigorous use of the forearm muscle. In particular, painters, plumbers, carpenters are prone to developing tennis elbow. As well some studies show that auto workers, cooks and butches get tennis elbow more than the rest of the population from the repetition and weight lifting that they do throughout the cause of the work day.
The symptoms of tennis elbow generally develop gradually and get worse over weeks and months. The pain is generally mild at first that is easily manages with NSAIDs or pain-killers but can get worse over time, and there’s generally no specific injury or accident associated with the start of the symptoms. Some of the most common symptoms include:
- Pain at the lateral (outer part) of the elbow that may or may not radiate down the forearm
- Weakness in grip strength or difficulty carrying items in their hand or holding objects such as a hammer
Lateral epicondylitis is generally managed through a non-surgical approach and about 80% to 95% of patients have success with non-surgical treatment. Most non-surgical treatment plans include some of the following options:
Rest: The first and most important part towards recovery, which may require several weeks of non-participation in sports or heavy work activities that cause irritation.
Non-steroidal anti-inflammatory medicines (NSAIDs): Common drugs like aspirin or ibuprofen to reduce the pain, inflammation and swelling.
Equipment check: Mainly applies to tennis players, but having a racquet strung too tight can place more stress on the forearm and cause lateral epicondylitis, as well an oversized racquet may cause more pressure as well.
Physiotherapy: A physiotherapist may give you specific exercises to strengthen the forearm, stretch the tight tissues, and use modalities such as ultrasound and ice massage to help reduce the pain and inflammation on the shoulder.
Brace: A brace on the back of the forearm may relieve the pressure on the lateral epicondyle and rest the muscles and tendons to help relieve the symptoms.
Steroid injections: Steroids are used in some cases that don’t respond to regular NSAIDs as they are very effective anti-inflammatory medicines and some doctors may inject a damaged muscle or tendon with steroids such as cortisone to relieve the symptoms.