Repeated use of the forearm muscles can overload the tendons attaching them to the outer elbow, often damaging the extensor carpi radialis brevis (ECRB). This overuse injury, known as tennis elbow, leads to tendon irritation, small tears, and swelling, which in turn causes discomfort and weakness when lifting or grasping objects.
Causes and Risk Factors
Tennis elbow typically develops from frequent, repetitive actions especially those that require strong gripping, rotational movements, or sustained wrist extension. While tennis and other racquet sports like squash and badminton can trigger the condition, many cases arise from non-sporting activities such as:
- Painting, carpentry, plumbing, or other manual jobs involving tools
- Typing or prolonged mouse use
- Gardening, lifting heavy bags, or repetitive household tasks
Risk factors:
- Age, most commonly affecting people between 30 and 50 years
- Occupations requiring repetitive arm movements or heavy lifting
- Poor technique in sports or work activities
- Weak forearm muscles that place extra strain on tendons
- Smoking, obesity, and sedentary lifestyle
Diagnosis of Tennis Elbow
Diagnosis often begins by carefully reviewing the patient’s medical background, then conducting a detailed physical examination. Your healthcare provider will assess tenderness over the lateral elbow, especially at the common extensor tendon origin, and may ask you to perform specific movements to reproduce pain.
Additional tests might include:
- X-rays to rule out arthritis or bone abnormalities
- MRI scans to assess tendon damage and exclude neck or spine issues causing referred pain
- Electromyography (EMG) to check for nerve-related problems
Treatment of Tennis Elbow
Most cases of tennis elbow are self-limiting but can persist for months or even years. Treatment focuses on:
- Rest and avoidance of painful activities
- Physical therapy: exercises to strengthen wrist and forearm muscles, stretching, and manual therapy
- Pain relief: ice, nonsteroidal anti-inflammatory drugs (NSAIDs), and sometimes corticosteroid injections
- Other modalities: bracing, taping, electrotherapy, and acupuncture may be used as adjuncts
- Surgery is considered only for severe, persistent cases unresponsive to conservative management
If symptoms persist despite these measures, further interventions may be considered:
- Steroid injections to reduce inflammation (though benefits may be temporary)
- Using sound waves in extracorporeal shock wave therapy to stimulate the body’s natural healing process
- Ultrasound-guided procedures like needle fenestration or ultrasonic tenotomy to remove damaged tissue
- Platelet-rich plasma (PRP) therapy to enhance tendon repair
Surgery is rarely needed but may be recommended if symptoms are severe and unresponsive to other treatments.
Preventing Tennis Elbow
Prevention focuses on reducing strain on the elbow tendons through:
- Regularly strengthening forearm muscles, especially eccentric exercises
- Using proper technique and suitable equipment in sports
- Taking frequent breaks during repetitive tasks involving gripping or wrist movements
- Maintaining good posture and wrist alignment during activities
- Wearing an elbow brace during high-risk activities to reduce tendon load
Conclusion
Tennis elbow is a degenerative condition of the tendons on the outside of the elbow, caused by repetitive strain. It leads to pain and tenderness, especially with gripping or wrist extension, and is managed with rest, physical therapy, and pain relief, with surgery reserved for stubborn cases. If you experience persistent elbow pain affecting your daily activities, consult your healthcare provider for a thorough evaluation and personalised care plan.
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