Tennis Elbow

Understanding the Symptoms, Causes and Treatments

Understanding Tennis Elbow

The elbow is a hinge joint that connects the upper arm and lower arm. It consists of three bones: the humerus, radius, and ulna. Each bone is capped with cartilage and a complex array of ligaments and tendons from various muscles that cross over the joint. Tennis Elbow, or lateral epicondylitis, is an overuse injury and inflammation of the common extensor tendons of the forearm as they attach to the lateral epicondyle, or outside part of the elbow.

Causes of Tennis Elbow

You do not need to be a tennis player to get tennis elbow! Most often this injury is due to oversue, especially with repetitive activities from certain jobs, sports, or home activities. Over time, the gripping muscles and tendons on the outside of the forearm/elbow sustain forces that exceed their capacity leading to micro-injuries. You may not notice these at first, but given enough time, the tendon starts having larger tears, gets thick, swollen, and inflammation starts to settle in causing pain and decreased function.

Symptoms of Tennis Elbow

Pain and tenderness over the outside of the elbow.
Stiffness in the elbow joint, especially in the morning
Pain with your grip
Difficulty lifting heavy items, especially with your palm facing down

Diagnosing Tennis Elbow

A comprehensive history and physical examination is the most important piece to determine if the common extensor tendons are involved in your elbow pain. X-ray, MRI, and/or ultrasound are imaging modalities that allow us to see the tendons and surrounding tissues.

Treatment Options

Prevention – Focus on stretching and strengthen the muscles with exercise and avoid nicotine.
Bracing may be needed to help of-load the tendon and facilitate healing
Physical therapy – To help build strength and improve function of the weak tendons.
Medications – NSAIDs or Tylenol may be recommended short term to help control symptoms while going through a physical therapy program
Steroid Injections – Strong anti-inflammatory medicine may be injected, typically under ultrasound guidance, to help reduce pain and inflammation in order to better facilitate physical therapy. Steroid injections are typically okay once for extremely painful elbows, but repeated injections are not recommended as they often weaken the tendon, leading to worse symptoms and outcomes down the road.
Regenerative medicine– Harnessing the body’s incredible power to heal itself, rebuild tissue, and avoid surgery. The best option is PRP to stimulate tissue healing and repair along with a course of physical therapy.