Tennis Elbow

Symptoms

The symptoms of tennis elbow develop gradually, and the pain starts off mild, worsening over time. Some common symptoms include:

• Pain or burning sensation on the outer part of your elbow
• Pain on lifting objects, gripping an object, or turning your wrist, e.g., turning a doorknob
• Pain on straightening the elbow
• Feeling the pain in the night
• A weak grip strength

Causes

Some causes of tennis elbow include:

Overuse
Studies have shown that tennis elbow occurs when a specific forearm muscle gets damaged. The extensor carpi radialis brevis (ECRB) helps to stabilise the wrist when the elbow is straight but when it is weakened from overuse, microscopic tears form in the tendon, leading to inflammation and pain.

Activities
Although the name makes it sound like only tennis players or athletes playing racquet sports suffer from this condition, the truth is that anyone who participates in work or activities that require repetitive and vigorous use of the forearm muscle are also at risk. This includes long periods of using the computer mouse, hanging up clothes, painting or plumbing work.

Age
Most patients with tennis elbow are middle-aged, ranging from 30 to 50. 

Unknown
Tennis elbow can also occur without any repetitive injury, even though it is quite rare. This occurrence is called “idiopathic”.
 
 

Golfer’s elbow 

A similar condition where there is pain or inflammation on the inner side of the elbow is known as golfer’s elbow (or medial epicondylitis), and this occurs when there is overuse of the flexor-pronator muscles of the forearm.
 
 

Diagnosis

Your orthopaedic specialist will start off with a physical examination to check your elbow, such as asking you to straighten your wrist and fingers against resistance. 

Depending on your presentation, you may also be required to undergo special investigations to rule out other causes of elbow pain, such as an X-ray, MRI scan or electromyography (EMG). 
 
 

Treatment

Tennis elbow is often first treated with non-surgical methods such as having proper rest, avoiding aggravating activities and taking anti-inflammatory medications. You may also be advised to wear an elbow support, and go through physical therapy, to first stretch and then strengthen the affected forearm muscles. If the pain persists, injections of steroids (to reduce inflammation) or platelet rich plasma (to stimulate healing) can be considered.

With recalcitrant cases causing significant disability, minimally invasive surgical interventions can be considered. Your orthopaedic specialist will remove the diseased muscle/tendon, stimulate healing within the surrounding tissue or reattach torn tendon back to the bone. These can be done through keyhole incisions under ultrasound guidance (TENEX procedure), or arthroscopic surgery. Less commonly, open surgery using small incisions may need to be used.

Every case is different; hence it is best to consult an orthopaedic specialist for an accurate diagnosis so that you can obtain the best treatment option that is most suitable for you. Reach out to us today if you suspect you are suffering from tennis elbow and let us help you enjoy a better quality of life.