Tennis Elbow

Tennis Elbow

Tennis elbow is a painful affliction that is also known as lateral epicondylitis, shooter’s elbow and archer’s elbow. Tennis elbow describes an affliction in which the outer area of the elbow becomes painful and tender, typically attributed to the playing of some sort of sport that uses the elbow such as tennis, racquet ball, and other similar sports. There is typically no inflammatory process identified with tennis elbow; however the pain can be quite severe.
Tennis Elbow
Tennis elbow is typically an ailment that occurs when there is overuse of the elbow, causing the muscles to become strained and tighten.

Tennis is not the only sport that is involved with causing or aggravating tennis elbow, as there are many sports associated.

Experience of tennis elbow involves a sharp and sore pain throughout the tendons within the forearm muscles that attach to the elbow, which can spread to the wrist.

Symptoms & Treatment Overview

There are many symptoms and there are many treatments. There are several prescription medications and over-the-counter medications as well that offer a great pain relief.

There are some newer medical practices that involve herbal remedies, and there are many people that choose home remedies to appease the pain of tennis elbow.

Surgery is a rarity for the painful affliction as there isn’t much benefit that surgery can provide outside of other treatments in typical cases.

Tennis elbow worsens through time without treatment and with continued overuse of the elbow and wrist. In the event that treatment is successful, there can be a reoccurrence due to reuse of the arm with stress that causes the injury to return.

Symptoms

The three most common symptoms of tennis elbow in order of presence include

  • Elbow pain that grows slowly worse
  • Pain when grabbing or twisting in the back of the hand up the arm to the elbow
  • Weakened grasp

There are more severe symptoms that indicate there may be an issue associated with the tennis elbow. These symptoms indicate that it is time for a visit to the physician as they could represent worsening conditions that require immediate attention.

If your elbow becomes hot to the touch and inflamed, with an accompanying fever, there could be an issue that needs to be addressed immediately.

Other symptoms include

  • Inability to move and bend elbow
  • Elbow begins to look deformed or misshapen
  • Feeling and appearance begins to resemble a broken bone

These symptoms indicate there may be a broken bone or a fracture that needs to be reset and casted in order to enable it to heal. Ignoring these symptoms could cause long term disability and decreased use of the elbow.

Watching for the symptoms of tennis elbow and knowing to distinguish between those and that of a broken bone or fracture can ensure that the appropriate treatment and attention is given to the ailment. Knowing the difference can increase healing time and encourage a quick recovery.

Causes

Tennis elbow usually occurs when there is overuse of the elbow leading to the repeated contraction of the muscles in the forearm. This can cause stress within the tissue and can cause several tears to appear within the outer muscle.

This is a very painful condition that can cause a severe decrease in use of the elbow as it can get extremely painful to move or stretch the arm. Even moving the wrist can become very painful and the most extreme cases could lead to inhibited use of the arm altogether.

There are several ways this overuse can occur, including

  • Playing tennis or similar sports
  • Plumbing
  • Painting
  • Raking
  • Weaving

Even repeated twisting of a screwdriver could cause this condition through overuse of the wrist. This condition can also be termed as insidious, or without a known cause, as it has been seen to sporadically afflict some individuals. This can be an occurrence without warning and without strenuous activity or any type of injury to the arm or elbow.

Risk Factors

There is a broad group that is at risk for developing tennis elbow. It is most commonly found in older adults between the ages of 30 and 50. Even young adults can be afflicted if there is strenuous and excessive stress on the wrists or elbow, causing tears in the extensor carpi radialis brevis.

Those in careers or recreational activities that cause this type of stress are at risk for the condition, but this does not ensure they will definitely develop it. It is also believed that other risk factors include starting these activities at an older age or performing strenuous activity as a beginner with no previous training or proper stretching procedures.

Prevention Tips

It is important that when beginning any type of job or recreational activity that puts stress on the elbow and wrist, appropriate stretching and warm-up is performed. This can ensure that the muscles are well toned and able to support the vigorous activity. It is also important to avoid repeating the same motion without breaking. Continuous repetition of a particular motion can increase the risk of developing tennis elbow.

When warming up, it is import to practice a bending and stretching warm-up that will provide some flexibility to the muscles. In the event repetitive motions were performed, proper cool down and application of an ice pack to the outer arm muscle extended from the wrist to the elbow is necessary and helpful in preventing tennis elbow.

Playing Safely

Ensure when playing sports that a professional critiques your movements to ensure they are correct. It has been seen that an improper tennis backstroke can cause tennis elbow, meaning that the improper moves could cause the condition.

Conditioning is important when playing sports as this builds the strength of the muscles and allows them to hold more restrain. When lifting, hitting, swinging, or any other arm movement, the wrist should remain as straight as possible to avoid excessive straight when bending or twisting. All equipment used during sports activity should be checked to ensure that there is a proper fitting and there isn’t a need for excessive strain on any part of the arm.

Test and Diagnosis Considerations

X-rays are an improper form of testing and diagnosing tennis elbow because the injury is within the muscle and won’t show up. The best way to diagnose the condition is by pressing the area to test for any tenderness and pain. If the pain seems to be more severe than common tennis elbow, then X-rays become a useful tool in identifying any breaks or fractures that could be causing the pain and need medical attention.

An X-ray can even identify if arthritis may be the culprit of the pain as well, however MRI scans are more commonly used for these identifications. These imaging studies are able to provide a more comprehensive, in-depth look at the muscles and all that may be afflicting the area.

An at-home test that is highly suggested is effective in identifying tennis elbow. There are specific steps that must be followed in order to properly perform the test and arrive at a credible result.

  • Stand behind a sturdy chair.
  • Place hands on top of chair’s back with palms down.
  • Attempt to lift the chair from the floor.

If after following these steps, there is a sharp pain on the outside of the elbow, tennis elbow may be the condition you need treatment for.

It is important to inform the physician of any strenuous activity that may be causing the issue and any sports or activities that is participated in. This can help to identify if tennis elbow is the problem. If there is a family or medical history of arthritis or any other types of nerve disease or disorders, the physician should be made aware of that as well, in order to ensure that proper diagnosis is possible.

Treatment Options

Treatment Options for Tennis Elbow

Nonsurgical treatment is a main objective for treatment of tennis elbow. More physicians than not prefer to stick with nonsurgical means through the use of therapies and medical treatments.

About 80 to 90 percent of patients afflicted with tennis elbow are successfully treated without surgery.

There are several alternative remedies, as well as medications that are used to treat this affliction, even devices that can be used to encourage healing and reduce occurrence and risk of tennis elbow.

Herbal and Home Remedies

Rest is a key element of treatment for tennis elbow. The arm should be given the appropriate amount of rest in order to promote healing and allow the muscle to improve.

This means stopping activities and any significant motion with the arm that causes stress on the wrist and elbow. Therapy that can be done at home includes ice and heated massage, stretching, and conditioning of the muscles to promote a quick and healthy healing process. Using a brace can also reduce the symptoms allowing the muscles and tendons to rest during use.

Zostrix is another home remedy that is a derivative of hot pepper that can be wrapped around the afflicted elbow joint. It has been seen to be effective in relieving pain and any present swelling. Warm baked potatoes have also been seen to provide a great heat compress that lasts for quite a while.

There are also very useful home remedies including

  • Drinking ten drops of celery extract and eating large amounts of celery
  • Flax seed and salmon to provide omega-3 fatty acid
  • Ginger tea consumed three times a day
  • Elbow massage with calendula oil

Medical Treatment

There are various drugs that can be used to treat tennis elbow and alleviate the pain. Such medicines include NSAIDs including Ibuprofen, Advil, and Aspirin. These medications can reduce the pain and swelling that may occur.

Steroid injections are commonly used in order to provide an effective anti-inflammatory effect. Cortisone is the most commonly used anti-inflammatory steroid injection used. It has been shown to have various side effects such as indentation to the area around the injection site due to hypopigmentation and fat atrophy. There is also the use of vibration therapy that has proven to be quite effective in providing inflammation and pain relief.

Use of acetaminophen such as Tylenol with codeine as well as other medications including

  • Motrin
  • Naproxen
  • Aleve

Side effects of NSAIDs include nausea, heartburn, peptic ulcer, or skin rashes, which are typically quite minor. More severe side effects include confusion, swelling of limbs, and decrease in urine. All NSAID medications should be taken as prescribed or directed on the packaging and with a full stomach.

Surgeries

If there have been unsuccessful nonsurgical attempts for 6 to 12 months concurrently, then surgery may be the most effective next step. This involves invasive surgery in which trained surgeons will remove the damaged muscle that shows disease and using healthy muscle to reattach to the bone.

There are different types of surgeries, mostly depending on the cause and scope of injury to the muscle, the physical health of the patient, and the personal needs as well. Open surgery is most common and involves an incision that is made above the elbow, typically performed as outpatient surgery. Arthroscopic surgery involves using tiny instruments in order to make small incisions to access and repair the diseased muscles.

There are various risks associated with performing the surgery to treat tennis elbow including

  • Infections
  • Nerve damage or blood vessel damage
  • Prolonged rehabilitation
  • Decreased strength and flexibility
  • Need for more surgery

Physical activity can usually resume four to six months after surgery has been performed, with 80 to 90 percent of patients reaching a successful conclusion. Physicians will recommend introduction of light exercise to help strengthen the muscles around two months after surgery has been performed.

Other Treatments

There are several other treatments that have been shown to be slightly effective in treating the condition including:

  • Acupuncture
  • Blood injection
  • Botulinum toxin
  • Heat therapy
  • Low level laser therapy

These treatments aren’t typically prescribed as the clinical trials to back them up have been less than credible and high quality. Acupuncture has been seen as somewhat effective and beneficial in the treatment of tennis elbow, but there has been no conclusive research to show that. If tennis elbow refuses to improve after various methods of surgical and nonsurgical treatments, there may be nerve entrapment present in the forearm that is inhibiting the healing of the muscles.

Tennis elbow can be a very difficult pain to deal with if treatment is not sought out promptly. Active individuals find this condition to be very debilitating as it eliminates the ability to participate in many sports and recreational activities.

Injury at the Workplace

If the job is the source of the aggravation to the wrist or elbow, there can be a decrease in productivity, leading to a decrease in income due to tennis elbow. There is no reason to not seek out treatment as the most common treatments and pain relievers are quite inexpensive and offer a simple and effective treatment. There are alternative treatments that are in use in some cases, but not widely promoted as they haven’t been shown to provide many benefits for those afflicted with the condition.

A physician should only be sought out after home treatment has been attempted and unsuccessful. The warning signs can signify that there may be something more complicated like a break or a fracture to the bone that may be masked by the signs of tennis elbow. If this occurs, it is imperitive that the appropriate treatment is immediately sought out to avoid long term deformation, pain, stiffness, and disability.

Effects of Non-Treatment

There can be severe effects of tennis elbow if allowed ot proceed with no attempts to treat or encourage healing of the muscles. When there is a presence of a more severe condition, it can typically be found most efficiently through an MRI or ultrasound.

This can aid physicians in providing the most comprehensive care and to ensure that all necessary treatments are in place. If there is a family history that shows instances that may have something to do with the pain that is felt, there may be further testing in order to provide a more thorough diagnosis and ensure that these illnesses or diseases aren’t causing the pain.

Maintaining Proper Treatment & Prevention

Once treatment has begun, it is important to maintain and manage the process. Ensuring that there is success along the way ensures that the treatments are beneficial and should continue. If there is a more severe case of tennis elbow, there may be more aggressive measures needed in order to properly treat and appease the affliction.

If tennis elbow does develop, or there is suspicion that it is developing, proper rest of the afflicted arm and appropriate care of the arm should be proceeded in order to ensure that it doesn’t get to an extreme level. Proper maintenance of the condition can ensure that there is a prompt and healthy healing process and that the condition adheres to the treatment that is used before more aggressive and invasive treatment is required.

Resources

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There are currently 1 comments. Add your's below!
  1. Leah 13 September 2011 at 7:49 pm permalink

    This was a very interesting article, I especially liked the prevention tips. Stretching is important before engaging in any activity that requires the intense use of muscles. Also, I feel that sometimes people forget that keeping your body healthy is not just about playing sport, but also a balanced diet. The effort required during intense training has to be sustained somehow and people need to understand that without eating properly and taking supplements the body cannot get all the vitamins and energy it needs to keep up the performance. Especially since there are so many great options out there: vitamin complexes, aceformula (aceformula.com), products containing acid leucine, or simply plain coffee.
    Hopefully, people do a bit of research before doing workouts without a trainer advising them.


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