What is tennis elbow?
Tennis elbow is a condition that causes pain around the outside of the elbow.
It is clinically known as lateral epicondylitis. It often occurs after overuse of the muscles and tendons of the forearm, near the elbow joint. You may notice pain:
You may also find it difficult to fully straighten your forearm.
How do we treat tennis elbow at the Mansfield Clinic?
Dr Allfree may use osteopathy techniques such as massage and manipulation, to relieve pain and stiffness, and encourage blood flow to your arm. He will also show you some exercises to keep your arm mobile and strengthen your forearm muscles.
You may also be advised to use a simple tennis elbow brace for the short term.
If your tennis elbow does not settle down, Dr Allfree may suggest using other more specialised techniques, including steroid injections, autologous blood injections, or Extracorporeal Shock Wave Therapy.
Tennis elbow causes pain on the outside of the elbow. There may also be pain in the forearm spreading down as far as the back of the hand. The pain of tennis elbow can range from mild discomfort while using the elbow, to severe pain that can be felt even when the elbow is still. Repetitive wrist movements, such as extending the wrist and gripping, tend to make the pain worse.
If you have tennis elbow you will usually experience:
An episode of tennis elbow will usually last between six months and two years. Sometimes it does not settle down on its own, and can become chronic without treatment. For this reason, it is always wise to have tennis elbow treated as soon as possible.
Tennis elbow is usually an overuse injury. It occurs when the muscles and tendons in your forearm are strained due to a repetitive or strenuous activity.
Tennis elbow can sometimes occur due to a specific injury, such as a bang on the side of the elbow. If the muscles and tendons in your forearm are strained, tiny tears can develop in the tendon where it inserts onto the bony prominence on the outside of your elbow.
You may get tennis elbow if your forearm muscles are not used to doing a certain activity, such as gardening or decorating. However, even if you use your forearm muscles frequently, you can still get tennis elbow.
You can develop tennis elbow by doing any form of activity that involves repetitive twisting of your wrist, and using your forearm muscles. Examples include:
Despite its name, only 5% of people actually get tennis elbow from playing racquet sports.
If your elbow pain is caused by a strenuous or repetitive activity, you should avoid the activity until your symptoms improve.
Get treatment if the pain in your elbow persists for longer than a few days, in spite of rest. Dr Allfree will examine you for swelling and tenderness, and do some simple tests to confirm the diagnosis, such as asking you to extend your fingers and bend your wrist backwards with your elbow extended.
Tennis elbow can often last for several weeks or months because tendons heal very slowly. In some cases, tennis elbow can persist for a year or more.
A number of simple treatments can help alleviate the pain of tennis elbow. The most important thing you can do yourself is rest your injured arm and stop doing the activity that caused the problem.
Using an ice pack for a few minutes several times a day can help ease the pain. Purpose-made ice packs are available from The Mansfield Clinic.
Avoiding or modifying activities
If you have tennis elbow, you should stop doing activities that strain affected muscles and tendons. If you use your arms at work to carry out manual tasks you may need to avoid these activities until the pain in your arm improves. You may be able to modify the way you perform these types of movements so that they do not place strain on your arm.
Painkillers and anti-inflammatories
Taking painkillers, such as paracetamol and ibuprofen, may help ease mild pain and inflammation caused by tennis elbow.
As well as tablets, anti-inflammatory medication is also available as a cream or gel. These are applied directly to a specific area of your body, such as your elbow and forearm. Topical anti-inflammatories are often recommended for musculoskeletal conditions, such as tennis elbow, rather than anti-inflammatory tablets, because they can reduce inflammation and pain without causing side effects, such as heartburn, nausea and diarrhoea.
If your tennis elbow is causing you more severe or persistent pain then you will need to seek further treatment. At the Mansfield Clinic, Dr Allfree may use osteopathic techniques, such as massage and manipulation, to relieve pain and stiffness and encourage blood flow to your arm. He will also be able to show you exercises you can do to keep your arm mobile and strengthen your forearm muscles.
The use of an orthoses, such as a brace, may also be recommended in the short term.
Corticosteroid injections are sometimes used to treat particularly painful musculoskeletal problems. Corticosteroid injections may help reduce the pain of tennis elbow in the short term. The injection will be introduced directly into the painful area around your elbow. Before you have the injection, you may be given a local anaesthetic to numb the area to reduce the pain. Dr Allfree is very experienced in treating tennis elbow with steroid injections.
Autologous blood injections
Sometimes if steroid injections fail to give long term relief, Dr Allfree will use a technique called Autologous Blood Injection. Very simply, this involves obtaining a small amount of the patient’s blood, and re-injecting this around the injured tendon.
Shock wave therapy
Shock wave therapy is a non-invasive treatment where high-energy shockwaves are passed through the skin to help relieve pain and promote movement in the affected area.
How many sessions you will need depends on the severity of your pain. The National Institute for Health and Care Excellence (NICE) states that shock wave therapy is safe, although it can cause minor side effects including bruising and reddening of skin in the area being treated.
Research shows that shock wave therapy can help improve the pain of tennis elbow in some cases. However, it may not work in all cases and further research is needed.
Surgery may be recommended as a treatment of last resort in cases where tennis elbow is causing severe and persistent pain, and it has not responded to the treatments described above. The damaged part of the tendon will be removed to relieve the painful symptoms.
It is not always easy to avoid getting tennis elbow, although not putting too much stress on the muscles and tendons surrounding your elbow will help prevent the condition getting worse. If your tennis elbow is caused by an activity that involves placing repeated strain on your elbow joint, such as tennis, changing your technique may alleviate the problem.
Listed below are some measures you can take to help prevent tennis elbow developing or recurring: