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Brief overview:
- What is tennis elbow or tennis elbow? A collective term for various disorders of the arm and elbow that are caused by the same form of strain, such as playing tennis.
- Causes: Repeated injury or overuse causes inflammation at the insertion of a forearm muscle.
- Symptoms: Pain occurs mainly when closing the fist and those affected cannot grip firmly.
- Diagnosis: An X-ray or MRI helps to make a clear diagnosis and can rule out other injuries or illnesses.
- Treatment: In the early stages, treatment is conservative (rest, local injections, compression and physical therapies). If this does not lead to success, surgery can provide relief.
- Prognosis: Conservative treatment is successful in over 90% of cases. After surgery, regular check-ups and physiotherapy are necessary.
Article overview
Definition and causes of tennis elbow
Tennis elbow is an inflammatory reaction of the muscle in the elbow or forearm. It affects the insertion of the extensor carpi radialis brevis muscle (forearm muscle) on the lateral epicondyle of the humerus (outer upper joint bone of the upper arm).
Tennis elbow is characterized by pain on the outside of the elbow, which can extend into the upper arm and forearm.
Tennis elbow is caused by repeated injuries or overuse.
The muscle region affected by tennis elbow © Andrea Danti | AdobeStock
Frequency of tennis elbow
The condition is one of the most common complaints in tennis. More men than women suffer from the condition, with the peak age being between 35 and 55 years.
Symptoms of tennis elbow
Tennis elbow causes localized pain when pressure is applied to the lateral epicondyle of the humerus. The pain can be triggered in particular when closing the fist. Those affected therefore find it difficult or impossible to grip firmly.
There is also pain when extending the wrist against resistance with the elbow extended.
Diagnosis of tennis elbow
An X-ray or MRI examination is also recommended to rule out other diseases. Similar symptoms are also caused by
- Synovitis of the elbow joint,
- a blockage of the radial head,
- a free joint body,
- a plica synovialis,
- supinator syndrome or
- ulnar nerve syndrome.
These must be excluded by the diagnosis.
There may also be changes in the cervical spine with degeneration of the 5th and 6th cervical vertebrae. The examining doctor should also take this into consideration.
Treatment of tennis elbow
The treatment of tennis elbow is divided into conservative and surgical treatment.
At the beginning of the disease, conservative therapy is used. The aim is to reduce the inflammatory reaction at the tendon insertion of the affected muscle. The following procedures are recommended in combination with each other:
- Rest
- Stretching of the extensors
- 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 modification of the tennis racket
Surgical treatment is necessary if symptoms persist after conservative treatment.
The most common surgical method is the Hohmann technique. This involves a tendon notch in the tendon of the extensor carpi radialis brevis muscle with denervation according to Wilhelm.
Aftercare following tennis elbow surgery
Aftercare following surgical treatment includes regular wound checks and physiotherapy.
The rehabilitation phase following surgical treatment can take up to six months.
Healing prospects for tennis elbow
Conservative treatment has success rates in the 90 percent range and is therefore the treatment of choice. Consequently, surgical treatment is only indicated in rare cases.