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Tennis Elbow Treatment in Singapore
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is Tennis Elbow?
Tennis elbow, medically known as lateral epicondylitis, results from overuse or repetitive movements of the forearm and wrist. This condition involves damage to the forearm muscles and tendons, which leads to pain and swelling.
Tennis elbow is not limited to tennis players. It can affect anyone engaged in activities that require gripping, twisting, or lifting, such as painting, typing, and playing musical instruments.
Causes of Tennis Elbow
Tennis elbow arises from a combination of factors, including the following:
- Overuse of the Elbow
The condition is commonly linked to the overuse of a specific forearm muscle, the extensor carpi radialis brevis (ECRB). This muscle helps stabilise the wrist when the elbow is straight. Overuse leads to microscopic tears in the tendon, resulting in inflammation and pain. - Repetitive and Vigorous Activities
Despite its name, tennis elbow is not exclusive to tennis players. It can affect anyone engaging in activities that require repetitive and vigorous use of the forearm muscle. This includes prolonged computer mouse use and tasks like hanging clothes, painting, or plumbing. - Age-Related Degeneration
Individuals between 30 and 50 years of age are often more susceptible to the condition. This is due to the cumulative effects of wear and tear on the tendons. - Idiopathic Causes
In some instances, tennis elbow occurs without any apparent repetitive injury, a condition referred to as “idiopathic.” This less common form of tennis elbow has no clear causative activity or injury.
Symptoms and Signs
The onset of symptoms in tennis elbow is typically gradual, with the pain initially being mild and intensifying over time. This pain is often felt on the outer part of the elbow and can extend into the forearm and wrist. Activities that involve lifting objects, gripping, or turning the wrist (like turning a doorknob) may exacerbate the pain. Straightening the elbow might also be painful, and this pain may increase at night.
Another noticeable sign is a weakness in grip strength. This can make everyday tasks challenging.
Diagnosis
The process of diagnosing tennis elbow typically involves a combination of clinical examination and, if necessary, imaging tests.
- Medical History - Diagnosis starts with a thorough review of the patient’s medical history and current symptoms. The elbow specialist may ask questions about the severity and location of pain, as well as any previous injuries the patient has sustained.
- Physical Examination - A physical examination of the elbow will also be conducted by the elbow specialist. This may involve pressing on the affected area or asking the patient to perform movements with the elbow, wrist, and fingers against resistance.
- Imaging Tests - While often the history and physical exam are sufficient, additional imaging tests like X-rays or MRI scans may be requested to help rule out other causes of elbow pain.
- Electromyography (EMG) - In some cases, an EMG may be conducted to evaluate the health of the muscles and the nerve cells that control them.
Non-Surgical Treatment Options
Non-surgical treatment methods are typically the first line of treatment for tennis elbow. They aim to effectively manage and relieve symptoms.
Rest and Activity Modification |
In less serious cases, the elbow specialist may suggest providing the affected arm with adequate rest and avoiding activities that exacerbate the symptoms. This helps reduce stress on the injured tendons. |
Anti-Inflammatory Medications |
Over-the-counter pain relievers such as ibuprofen or naproxen sodium are often used to alleviate pain and reduce inflammation. |
Physical Therapy |
Physical therapy involves exercises that stretch and strengthen the forearm muscles. Techniques like ultrasound or manual therapy may also be employed to promote healing and reduce inflammation. |
Elbow Supports |
Utilising elbow braces or straps can aid in recovery by reducing stress on the injured tissue. |
Steroid Injections |
In cases where pain persists, injections of corticosteroids might be considered to reduce inflammation. |
Platelet Rich Plasma (PRP) |
PRP injections can also be used for persistent pain. This involves using a concentration of the patient’s platelets to stimulate healing in the affected tendons. |
Surgical Treatment Options
When non-surgical treatments do not provide sufficient relief or for more persistent cases of tennis elbow, surgical intervention may be considered.
TENEX Procedure
This uses ultrasound guidance to remove diseased muscle or tendon tissue. This approach stimulates healing in the surrounding tissues and can often be performed through small, keyhole incisions.
Arthroscopic Surgery
Alternatively, arthroscopic surgery may be employed. This technique uses several small incisions and special instruments to repair the damaged tendon.
Open Surgery
In some cases, open surgery might be necessary. This involves making larger incisions to remove the damaged tissue and reattach the tendon to the bone.
Prevention Strategies
To reduce the risk of developing or exacerbating tennis elbow, the following strategies may be considered.
- Modifying Activities to Reduce Strain: Modifying activities that cause pain can help prevent stress on the elbow and forearm. This may involve adjusting techniques or using ergonomic tools.
- Using Proper Technique and Equipment to Prevent Injury: For sports enthusiasts, particularly those playing racquet sports, proper technique can help reduce unnecessary strain on the forearm muscles. Using lightweight tools or racquets and increasing grip size can help minimise tendon strain.
- Perform Warm-ups Before Repetitive Arm Movements: Engage in warm-ups before activities that involve repetitive arm movements. This helps prepare the muscles and tendons for the activity ahead.
- Elbow Strengthening Exercises: Regularly performing exercises to strengthen the forearm muscles can reduce the risk of injury.
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 20 years of experience, Dr Poh Seng Yew (傅圣耀) is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
Can a Tennis Elbow Heal on Its Own?
While tennis elbow can show improvement with rest and conservative measures, medical intervention is often beneficial. If symptoms persist, consult our elbow specialist for appropriate management strategies to prevent complications.
Can Tennis Elbow Affect Both Arms?
Tennis elbow can indeed develop in one or both arms, often due to repetitive strain or overuse. Seek individualised treatment for each arm if affected.
What Happens If Tennis Elbow Is Left Untreated?
Neglecting tennis elbow may lead to chronic pain, a decrease in grip strength, and potential long-term disability. Early consultation with an elbow specialist can prevent the progression of the condition and facilitate effective treatment.
How Long Does Tennis Elbow Take to Heal?
The healing duration for tennis elbow varies, depending on the severity and the treatment approach. Generally, recovery can span from a few weeks to several months.