Tennis elbow, also known as lateral epicondylitis is a condition causing pain. If you participate in racquet sports or follow such events closely, then you may have heard about the condition. You suffer from it due to the overloading of the tendons in your elbow. It usually occurs due to the repetitive motions of the arm and wrist. While the name may give you the feeling that, only people playing tennis suffer from the condition, it is not the case. Other people who have occupations requiring repetitive hand or wrist movements like carpenters, plumbers, butchers, and painters can also suffer from the issue.
You feel pain in the elbows where the tendons attach to the bony bump located outside the elbow. Due to the condition, you can feel pain spreading into the forearm as well as the wrist. In most cases, you can overcome the problem with a little care and rest. Mild cases heal without any issue. But, severe cases may not respond to conservative treatments and requires surgery to overcome the problem. Read ahead to know more about the problem and how to deal with the condition.
Symptoms Of Tennis Elbow
Due to lateral epicondylitis, you can experience pain radiating from the outside of your elbow into the forearm as well as the wrist. It results in pain and weakness that makes it difficult to perform the following:
- Turn a doorknob
- Shake hands
- Hold a coffee cup
- Grip an object
When you experience pain, you try some home remedies like resting or icing. You can also try some over-the-counter pain killers to overcome pain as well as tenderness. But, when you feel no relief, then it is better to get medical help.
Causes Of Tennis Elbow
You suffer from tennis elbow due to repeating incorrect movements of your arm. Due to wrong techniques or movements, you develop small tears in the tendons attached to your elbow. While it is common among racquet players who repeat the motion of hitting a ball with force. So, it is a common issue among tennis players, hence the name. When you follow an incorrect technique to hit the ball, it results in the racquet swing power to rotate around and through the wrist. So, it creates a wrist movement instead of a shoulder or an elbow joint. This action increases pressure on your tendon, which results in inflammation and irritation.
In most cases, this tendon breakdown can cause the extensor muscles to trigger pain. Wondering what extensor muscles are? They are the muscles that straighten your wrist. Lateral epicondylitis can make it difficult to flick the wrist or snap it, which is necessary when you play racquet games.
Other Causes Of Tennis Elbow
The specific tendon injury can occur due to overuse. So, apart from racquet players, others can also experience the problem. With the following repeated daily activities, the condition can arise:
- Cutting tough food
- Using scissors
- Swimming
- Gardening
- Sports involving a high amount of throwing
Work like typing, plumbing, or bricklaying (manual work requiring repetitive lifting or turning of the wrist)
In some people, the condition arises due to no apparent cause.
Risk Factors Associated With Tennis Elbow
People who perform repetitive tasks with their hands can suffer from tennis elbow. But, some people are more at risk of the problem compared to others. The following risk factors make you susceptible to the problem:
Age
While lateral epicondylitis affects people of all ages, it is common among adults who are thirty years or more. The risk is higher for people between ages thirty and fifty years.
Certain Occupation
People who have occupations requiring repetitive motions of wrist and arms can develop the condition. So, people who have the following job can develop lateral epicondylitis:
- Carpenters
- Plumber
- Cooks
- Butchers
- Painters
Active In Certain Sports
If you are participating in racket sports, then you are an increased risk of suffering from the condition. It is specifically true for people who employ poor stroke technique. So, people playing tennis, badminton, table tennis, squash, and others need to maintain caution.
Diagnosing Tennis Elbow
When you suffer from pain while twisting, grasping, or lifting the objects, then consult a doctor. You must also make an appointment with the doctor if you suffer from the work-related problem due to elbow pain. Most people get relief from a mild form of the condition after two weeks of home treatment. But, if the pain becomes severe or does not go away, then your doctor suggests other techniques for alleviating the condition.
Test At Home
You can detect the condition easily at home with a simple test. Just stand behind a chair. Place your hands on the back of the chair at its top. You need to keep your elbows straight and place the palms facing downwards. Now, try to lift the chair. If you feel pain on the elbow’s outside, then it indicates lateral epicondylitis.
Physical Assessment
Based on your assessment at home, make an appointment with the doctor. Your doctor will test a range of motion with your arm. It is also important to convey the nature and location of pain you suffer for a proper diagnosis. In most cases, physical assessment can reveal the presence of lateral epicondylitis.
Imaging Tests
The doctor may suggest imaging tests like x-ray and MRI scans to rule out severe underlying conditions like elbow joint injury or arthritis. X-ray offer information about any injury you have suffered in the elbow. But, MRI is more sophisticated as it offers a detailed image of your arm, including muscles, soft tissues, and tendons. Imaging tests are required when the outer elbow pain does not ease after undergoing conservative treatments for more than six months.
Electromyography (EMG)
EMG is a test measuring the electrical activity or muscle response to a muscle’s nerve stimulation. It is a test used to uncover any neuromuscular abnormalities like nerve compression triggering a tennis elbow.
Treatment Options To Alleviate Tennis Elbow
Depending on the severity of the problem, you have different treatment options available. For mild cases, you can manage the condition at home with some care as well as caution. Based on your condition, the options available are:
Rest
Resting your arm is important to manage lateral epicondylitis. So, you need to take a break from activities causing the problem. It helps the tears you suffer in the tendon attachment to heal.
Non-steroidal Anti-Inflammatory Drugs
To manage pain, the doctor prescribes taking NSAIDs. Medications like ibuprofen or aspirin reduce pain and swelling associated with the condition.
Ice Massages
Your doctor also recommends ice massages. So, you need to ice lateral elbow for at least five to ten minutes until your skin feels cool to touch. You can either use a cup filled with water as well as frozen or hold an ice-covered towel. When the ice is too cold and feels uncomfortable on your skin, then you can place a damp cloth on the affected area. Then, place ice on top of the damp towel. You can use it as required to ease swelling or aching.
Physical Therapy
Physical therapists suggest a set of exercises for people performing repetitive actions or racquet players to strengthen their abdominal, upper arm, and shoulder muscles. So, it will help reduce wrist extensors when you move your arm and shoulders.
Strapping/Taping The Forearm
It is the technique designed to support your elbow. It also reduces the stress on the lateral epicondyle and forearm extensors. So, taping supports the affected area and realigns the muscle fibers. As it relieves pressure on the area, you will feel relief. It is used as a treatment and preventive option to overcome pain. Your doctor recommends using it for at least two to three weeks to keep the elbow out of action.
Steroid Injection For Managing Tennis Elbow
When you suffer from severe pain and it becomes difficult to move your hand, then your doctor recommends a steroid injection. Once the doctor takes the steroid injection, then you need to rest the arm. Never put too much strain on it.
Extra Corporeal Shock Wave Therapy
ESWT is a technique used by the doctor to ensure healing. The technique ends the sound wave to your elbow and stimulates inhibition of pain receptors along with soft tissue healing. When hyper-stimulation of the affected area occurs, it reduces your distress. The technique also increases the blood supply, which reactivates or facilitates the healing process.
Surgery For Tennis Elbow
When non-invasive treatment fails to treat lateral epicondylitis, then the doctor recommends surgery. It is usually suggested when conservative treatments fail to respond after six to twelve months of other treatments. In most of the surgical options, diseased muscle is removed and reattached with a healthy muscle back to your bone. Different surgical options are available for treating lateral epicondylitis. The right treatment depending on the following factors:
- The severity of your injury
- Your overall health
- Personal preferences
Based on the above-mentioned factors, your doctor suggests the surgical option from the following options:
Open Surgery For Tennis Elbow
It is the most common approach suggested by the doctor for lateral epicondylitis. The surgeon treats the problem after making an incision over the elbow and takes the damaged part of the tendon. Then, the surgeon reattaches the healthy part back to the bone. For better healing and proper blood circulation, a part of the bone is also removed.
Arthroscopic Surgery
During the procedure, the surgeon makes tiny cuts. A few cuts over the elbow allows camera into the holes along with surgical instruments to remove the damaged part of the tendon. After the surgery, the cuts are stitched and the surgeon places bandages over the cuts for wound healing.
After any of the surgery, you need to wear a wrist splint or an arm brace for preventing further damage to the tendons. You can take it off while you sleep or rest. In some cases, you need rehabilitation to regain natural movement. The doctor or physiotherapist offers advice regarding the best type of splint or brace.
Platelet-Rich Plasma Injection
It is the new therapy that is gaining a lot of attention. While studies regarding its effectiveness are still on way, the injection type therapy has offered good results to several people. For PRP injection, the concentration of the patient’s platelets is used for quick healing. Scientists believe using the patient’s healing system as a therapy improve musculoskeletal problems.
Home Remedies For Tennis Elbow
Suffering from shooting pain in your forearm? Are you finding it difficult to do simple chores like opening the door? Then, you need to suspect the tennis elbow as the main reason for the condition. Contrary to what the name indicates, the condition is not limited to tennis players. Anyone who overuses their forearms can suffer from the condition. So, people who complete day-to-day activities like using a computer mouse or cutting vegetables/meat repeatedly can trigger the use. If the pain is mild, then you can try some effective home remedies.
Massage With Essential Oils
Certain essential oils like lavender oil and lemongrass oil are well-known for healing ailments. These multipurpose oils can offer relief from pain due to their anti-inflammatory properties. Lavender oil is the most popular oil due to its versatility. It is also known for relieving pain with its analgesic properties. So, you can use these essential oils to massage and heal inflammation associated with lateral epicondylitis.
Before massaging, mix the essential oil with a carrier oil (like olive oil, almond oil, etc.). Mix twelve drops of the essential oil in 30ml of carrier oil and massage it over your forearm as well as other aching areas. Leave the oil for at least thirty to sixty minutes and wash it off. You need to do this massage for at least one to two times a day to see relief from pain caused to the condition.
Golden Milk
Turmeric milk or golden milk is often used as home remedies to treat cold and other ailments. Turmeric is known for its immune-boosting properties. It is because turmeric contains the magic ingredient known as curcumin in it. It not just speeds healing, but also offers you relief from inflammation and pain. So, you can drink the milk to get relief from lateral epicondylitis. To prepare golden milk, you need to add a teaspoon of turmeric powder in a glass of hot milk. When it cools down a bit, add honey to it and drink it when it is still warm. Drink the mixture for at least one to two times a day to see results.
Apply Castor Oil
Applying castor oil to your elbow can offer you relief as it contains a compound called ricinoleic acid. The anti-inflammatory properties of ricinoleic acid when combined with heat can reduce inflammation and pain. So, you need to apply a tablespoon of the castor oil on your elbow and massage. Then, place a hot water bottle on the area and leave it for at least fifteen to twenty minutes. For better results, repeat it a couple of times.
Deep Tissue Massage
Deep tissue massage is one of the popular home remedies for tennis elbow. It offers a wide range of benefits. The technique is used by several people to get relief from chronic aches. It also offers relief from the following issues, including lateral epicondylitis:
- Lower back pain
- Stiff neck
- Sore shoulders
The massage therapist uses firm and slow strokes on the affected area to reach deeper layers of your muscle as well as fascia. It aids in getting relief from pain, inflammation, and disrupted circulation.
Preventive Measures To Avoid Tennis Elbow
Can you prevent tennis elbow? Yes, with some caution and care, you can prevent lateral epicondylitis from affecting your life. Here are some steps you can follow:
Avoid Repetitive Tasks
People who participate in one particular sport of high impact activities or perform any hitting movements with your arm repetitively, then you need to consider adding a cross-training regime. It will help offset the high impact, repetitive activities.
Start Slowly
If you are resuming any sporting event involving your hand after a long time, then start slow. You need to ease back into the play. So, take a few weeks to build your strength. It is essential to return to your previous form and technique without any injuries. So, rest when you are tired and ease into the sports. Remember, you cannot achieve your previous form overnight. So, slowly build your strength and return to the proper form as well as technique. When you become more tired, the higher are the chances to suffer from injuries due to breaking proper form.
Cross-Training Regime
For people involved in high impact or sports with hitting movements with your arm, adding another regime like cross-training can prove beneficial. These exercises spread the cumulative orthopedic stress levels over your additional joints as well as muscles. So, you can use the forearm for longer durations without overloading the vulnerable areas. It also improves your muscle’s strength and fitness.
Do Forearm Exercises
To keep your forearm fit, you need to perform simple wrist exercises. The flexion and extension exercises target your muscles in the forearm. Since your forearm muscle is attached at the elbow, you need to make it strong. It is specifically needed for people who work with their arm strenuously.
Take Breaks To Prevent Tennis Elbow
Your body signals when it needs rest. You must listen to your body. When your arm becomes sore, you need to take a break. It is needed for people who play sports requiring a lot of arm movements. So, when you feel soreness, it indicates your body needs a break. Taking breaks between matches will avoid any soreness or injury. When you feel pain, apply ice. Placing ice packs twice a day can ease pain and inflammation.
Regular Exercise
You need to use the muscles daily, else you become vulnerable to injury when you start a new sport like tennis. So, you need to adopt a physical conditioning regimen to avoid the high risk of getting the muscles injured. Follow an exercise regime to make the muscles strong as well as flexible. It will help the muscles bear stress. Include a stretching routine that will help your muscles. Move them up and down by performing exercises like push-ups, bending as well as stretching of the arm, and rotating arm to improve the strength of your arm muscles.
Follow Proper Technique
You need to follow proper technique while lifting heavy objects or playing games like techniques. When you are lifting, irrespective of the heaviness of the object, you need to keep the palms facing the body. You need to keep the arm bent to avoid the stress of the muscles. This posture will help transfer the stress on the larger muscles present in the back, biceps, and chest from forearm muscles as well as tendons.
When you are playing sports like tennis, it is better to hire a professional coach to learn the proper form and technique of the game. It is a crucial step in avoiding the overuse of the muscle in the wrong way. So, it prevents lateral epicondylitis from developing. When you have a sloppier form, you face a greater risk of injury. By following a good technique, you can play for a longer time. It is because you have reduced stress on the smaller muscles as well as tendons. So, you can have fun playing without feel exhausted faster.
Give Importance To Warm Up And Stretch
Warm up and stretch, hold the utmost importance before you engage in physical activity of any kind. It gets the blood pumping to your muscles. So, it enhances muscle flexibility and improves the range of motion. Warm-up and stretch can also help bear additional stress when you undertake any physical activity. Therefore, it reduces the risk of suffering from an injury.
Check The Equipment
In most cases, lateral epicondylitis occurs in people playing tennis. Such people who play professionally need to ensure they use the right equipment. A heavier, larger, or smaller can cause unnecessary stress and strain on the arm. So, use a tennis racket with a lightweight racket. A flexible racket with not too large handle is a perfect choice. Always buy the product from the tennis pro shop as you can find the right one with a proper fit.
Consider Using A Tennis Elbow Strap
If you suffer from lateral epicondylitis, then choose to wear a tennis elbow strap as early as possible. When you opt for it during the first few days of suffering, it can avoid the problem from worsening. You can wear the types of brace below your elbow. It reduces stress to the muscle when you play tennis. Tennis elbow strap also scatters pain throughout the forearm. It puts pressure on the tendon to reduce pain. While using it, avoid pulling the strap too tight as it can cut off the blood circulation in the arm.
Conclusion
Tennis elbow is a painful condition, which can go away when you take enough rest. You can also take over-the-counter painkillers to alleviate the distress. But, severe cases may not heal with conservative treatments. So, get the advice from a doctor when you see no change in the condition or see the condition worsening. Certain conditions require invasive treatment to alleviate pain. The right treatment is suggested by the doctor based on your condition. Therefore, get advice from the doctor.
References
https://www.webmd.com/pain-management/tennis-elbow
https://www.mayoclinic.org/diseases-conditions/tennis-elbow/symptoms-causes/syc-20351987#:~:text=Tennis%20elbow%20(lateral%20epicondylitis)%20is,people%20who%20develop%20tennis%20elbow.
https://orthoinfo.aaos.org/en/diseases–conditions/tennis-elbow-lateral-epicondylitis/