Understanding Tennis Elbow (Lateral Epicondylitis)

Tennis elbow refers to pain and tenderness on the outside of the elbow caused by inflammation of one of the tendons that join the forearm muscles to the elbow. The forearm muscles and tendons become damaged from overuse. Pain can be felt in the forearm and wrist as well.

Tennis elbow is typically caused by the motion of a tennis downstroke. The muscle of the forearm becomes weakened from overuse. Small tears can form in the tendon fibres that attach the muscle to the elbow, leading to pain and inflammation.

As the elbow bends and straightens, the muscle rubs against bony bumps in the forearm, which can cause gradual wear and tear of the muscle over time.

Tennis Elbow symptoms

The symptoms of Tennis Elbow are similar to those of Golfer’s Elbow. The difference is that Tennis Elbow causes pain on the outside of the elbow.

Other symptoms include:

• Pain spreading down the arm towards the wrist.
• Worsening pain when using the forearm such as bending, writing, holding a racquet, turning a wrench, or fully extending the arm.

Tennis Elbow risk factors

• Tennis Elbow can happen to anyone who uses their forearm muscle regularly. It is common in painters, plumbers, carpenters, cooks, and butchers.
• Common in people aged 30-50 years old.
• Those active in racquet sports such as badminton, tennis, or squash are at a greater risk of tennis elbow, especially if improper stroke techniques are used.

Tennis Elbow diagnosis

Your doctor would first question your general health and symptoms before conducting a thorough physical examination.

Diagnosis is made based on your reported symptoms, physical examination, and investigations.

Imaging tests such as an X-ray may be ordered so your doctor can confirm the diagnosis while ruling out other injuries associated with the elbow.

Tennis Elbow treatment options

Non-surgical treatments

• Rest with no sports or heavy work activities for several weeks.
• A brace centred over the back of your forearm, which may help to relieve symptoms by resting the muscles and tendons.
• Check your racquet for correct fit to prevent symptoms from recurring.
• Rehabilitation and pain relief exercises for tennis elbow.
• Medications such as painkillers or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can relieve pain and swelling.
• Ultrasonic tenotomy (TENEX) is a non-surgical procedure that removes damaged tissue on the tendons. The doctor will insert a special needle into the damaged part of the tendon. Ultrasonic energy will liquify the damaged tissue, which will then be suctioned out.
• Corticosteroid injection may be recommended to reduce inflammation if you are not responding well to the treatments above.

Surgical procedures

Surgery is usually only considered if all other treatments have not been successful.

The surgeon will make a cut above the bone on the side of your elbow to remove the damaged parts of the tendon during an open surgery.

During the minimally invasive procedure called arthroscopy, the surgeon will make a few tiny cuts on the skin over your elbow. Small instruments and a camera will be inserted into the holes to guide the surgeon to remove the damaged parts of the tendon.

Make an appointment at Gleneagles Hospitals

If you are experiencing any of the symptoms of Tennis Elbow, get in touch with us to find out more about our Orthopaedic Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with orthopaedic specialists to assist patients through diagnosis and treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.