Tennis elbow is a common elbow condition caused by overuse of the tendons and muscles in the forearm. Typical symptoms of tennis elbow include pain on the outside of the elbow and discomfort when gripping or lifting. Tennis elbow, also known medically as epicondylitis or epicondylitis humeri radialis, often affects people who perform repetitive one-sided movements.
The pain in the elbow can radiate into the forearm, wrist, or forearm muscles. In addition to tennis, prolonged strain from daily activities or work can also cause tennis elbow. Treatment for tennis elbow includes therapy, physical therapy, manual therapy, as well as bandaging and stretching exercises. The goal of treatment is to relieve pain, improve mobility, and prevent chronic symptoms.
Definition, Causes, and Risk Factors of Tennis Elbow
Tennis elbow refers to an inflammatory reaction in the muscles of the elbow or forearm. It affects the attachment of the extensor carpi radialis brevis muscle (a forearm muscle) to the lateral epicondyle of the humerus (the outer bony protrusion of the upper arm).
Tennis elbow causes pain on the outside of the elbow, which can radiate into the upper and lower arm. Tennis elbow is caused by repetitive injuries or overuse.
How common is tennis elbow?
Tennis elbow is one of the most common conditions affecting the outer elbow. According to estimates, about one in ten adults will develop symptoms related to this overuse injury at some point in their lives. People between the ages of 35 and 55 are particularly affected, with men developing the condition slightly more often than women.
Symptoms of tennis elbow do not occur only in athletes playing sports such as tennis, but just as frequently in people engaged in manual labor or those whose daily activities subject their upper and lower arms to heavy strain—such as through repetitive lifting, screwing, or working at a computer.
Some patients report that symptoms can persist for months if no targeted treatment is provided. Tennis elbow should be diagnosed and treated early to prevent it from becoming chronic.
Typical Symptoms of Tennis Elbow
Symptoms of tennis elbow include typical pain on the outside or inside of the elbow, which intensifies especially during activity and can radiate throughout the entire arm. Even simple activities like holding a cup can trigger severe discomfort.
Those affected often find it difficult to use their full range of motion in the arm. Pain occurs particularly when gripping firmly or rotating the wrist, and can radiate into the forearm muscles.
During a physical examination, doctors assess which movements exacerbate the pain. Manual tests are also used in this context.
If left untreated, the condition in the elbow can become chronic. In addition to traditional therapies, special procedures such as Botox injections may be used in some cases when standard treatments are insufficient.
Diagnosis of Tennis Elbow: Methods and Tests
An X-ray or MRI scan is also recommended to rule out other conditions. Similar symptoms can also be caused by
- synovitis of the elbow joint,
- a blockage of the radial head,
- a loose body in the joint,
- a synovial plica,
- supinator syndrome, or
- ulnar syndrome.
These must be ruled out during diagnosis. There may also be changes in the cervical spine with degeneration of the 5th and 6th cervical vertebrae. The examining physician should also take this into account.
Treatments for Tennis Elbow—Conservative and Surgical
Treatment for tennis elbow is divided into conservative and surgical approaches. Traditional therapy is the first line of treatment when symptoms first appear. The goal is to reduce the inflammatory response at the tendon insertion of the affected muscle and to relieve pain. The following procedures are recommended in combination:
- Rest
- Stretching of the extensor muscles
- Ultrasound
- Iontophoresis and electrotherapy
- Transverse friction of the tendon insertion
- Compression with bandages (epicondylitis bandages)
- Local injections, e.g., with cortisone
- General measures such as modifying the tennis racket
Surgical treatment is necessary if symptoms persist after traditional therapy. The most common surgical method is the Hohmann technique. This involves making an incision in the tendon of the extensor carpi radialis brevis muscle, followed by denervation according to the Wilhelm method.
Postoperative Care and Rehabilitation Following Tennis Elbow Surgery
Follow-up care after surgical treatment of tennis elbow (epicondylitis humeri radialis) involves more than just regular wound checks. Immediately after surgery, follow-up medical examinations and a physical examination are conducted to assess the healing process and range of motion.
An important component of rehabilitation is targeted physical therapy, which aims to strengthen the forearm muscles and the wrist and to prevent future strain that triggers pain. In addition, bandages or orthoses may be used to relieve pressure.
In addition, traditional treatments such as electrotherapy, pain-relieving injections, or manual therapy are often used during rehabilitation. The goal is to restore elbow mobility, reduce pain, and prevent long-term strain while working or playing tennis.
Depending on the severity of the condition and the type of procedure, the rehabilitation phase can last several months. In some cases, it can take up to half a year to fully regain full functional capacity.
Chances of Recovery and Prognosis
Traditional treatment has a success rate in the 90 percent range and is therefore the treatment of choice. Consequently, surgical intervention is indicated only in rare cases.
FAQ
What is tennis elbow?
Tennis elbow, or lateral epicondylitis, is an inflammation of the radial epicondyle on the outer side of the elbow. The condition is usually caused by overuse of the tendons, muscles, and tissues in the forearm. Pain on the outer side of the elbow is a typical symptom of tennis elbow.
What are the symptoms of tennis elbow?
Typical symptoms of tennis elbow include pain in the elbow, discomfort during activity, and limited range of motion. The pain from tennis elbow can radiate down to the wrist or forearm. Elbow pain often occurs when gripping or lifting objects.
How is tennis elbow diagnosed?
Tennis elbow is usually diagnosed through a physical examination of the elbow. Doctors assess pain in the elbow area, tolerance to stress, and range of motion. In some cases, an MRI is also used to rule out other conditions.
What is the treatment for tennis elbow?
Treatment for tennis elbow includes physical therapy, manual therapy, bracing, and stretching exercises. The goal of treatment is to relieve pain and reduce strain on the muscles. In cases of chronic tennis elbow, further treatment may be necessary.
How can you prevent tennis elbow?
To prevent tennis elbow, you should avoid movements that place one-sided strain on the arm and take regular breaks. Stretching, strengthening the forearm muscles, and using ergonomic movement patterns help prevent typical symptoms. It is especially important to recognize overuse early on and reduce the strain.
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