The elbow is comprised of 3 bones (the humerus, or arm bone, meets the radius and ulna) which form a hinge joint. The outside (or lateral) area of the elbow can become inflamed after repetitive exercise because nearly all of the muscles that extend your wrist and fingers attach at one point. Pain can occur after small micro tears and degeneration of the tissue occurs from repetitive movements. This is called tennis elbow or lateral epicondylitis.
Tennis elbow is common in 30-50 year olds, and often from non-athletic activities (“But Doc, I don’t play tennis!”). A similar problem can occur along the inside of the elbow, called medial epicondylitis or golfers elbow. The treatment is similar to tennis elbow.
Patients will often present with pain on the outside of the elbow worsened with activity or pressure. Non-operative treatment is fortunately 95% successful; however, it can often take a long time to resolve the symptoms. I usually recommend a counter brace (pictured) and regular ibuprofen/naproxen use; if this fails one cortisone injection. I prefer not to provide multiple injections into the area as the ligamentous complex that stabilizes the elbow is close to the injection site and can be disrupted from repetitive injections.
Surgical treatment is offered with worsening symptoms or restrictions after 3 months or a failure of conservative treatment after 6 months. I prefer to do this procedure arthroscopically (picture) but also will perform ultrasound shockwave therapy (so called fast-procedure, or Tenex) in select patients.
Tennis Elbow Symptoms
Many patients do not realize they are experiencing tennis elbow (aka lateral epicondylitis) due to the fact that the associated symptoms develop over time. At first, the symptoms can be quite mild, which results in patients disregarding the condition, seeing their discomfort as nothing more than usual aches and pains.
Unfortunately, however, if left untreated, symptoms will worsen.
Below are some of the most common signs of tennis elbow:
- Pain in the elbow or forearm when lifting something
- Pain when making a fist or gripping an object
- Shaking or unsteady hands
- General weakness of the elbow or forearm
- Tenderness on the outside (back) of the elbow
- Stiffness in the elbow or forearm (specifically in the morning)
Causes of Tennis Elbow
There are a myriad of reasons why a person might experience elbow pain, or develop tendonitis of the elbow. One of the most common tennis elbow causes is overuse, which can be the result of a range of repetitive activities involving the arm, including: hammering, painting, swinging a baseball bat, or gardening.
Some other tennis elbow causes include:
- A direct blow to the elbow
- Abnormal bone formation
- Forgetting to warm up before engaging in strenuous activities
- Using some forms of medication, including fluoroquinolone antibiotics
Tennis Elbow Risk Factors
There are certain activities and determinants that put a person at an increased risk of developing tendonitis of the elbow.
These risk factors include:
- Frequent use of vibrational hand tools (i.e. Jackhammers, chainsaws, etc.)
- Being above the age of 40
- Having a history of smoking
- The presence of De Quervain’s disease
- The presence of Carpal Tunnel Syndrome
How is Tennis Elbow Diagnosed?
With more than 15 years of experience in the orthopedic niche, Dr. Schwartz is unique qualified to identify and diagnose elbow conditions.
Typically, to begin, Dr. Schwartz will meet with a patient who is concerned about elbow pain conduct an introductory examination to pinpoint any key warning signs. This includes asking questions about the type of pain or discomfort the patient has been experiencing, what types of activities they have been engaging in, when the pain is most prominent, and whether or not there is a history of previous injuries.
After these questions have been addressed, Dr. Schwartz will move on to the physical portion of the examination. This is highly important, since lateral epicondylitis can often be easily identified if pain is present when the lateral epicondyle (the bump on the outside of your elbow) is pressed.
From there, it is likely that Dr. Schwartz will recommend an imaging test to gain a more in-depth look at any wearing, tearing, or inflammation that may be present beneath the skin.
What Should I Do If I Suspect I Have Tennis Elbow?
If you are experiencing any of the signs of tennis elbow, the most important thing to do is protect the elbow and seek immediate treatment.
Below are some recommended precautions to take while you await professional care:
- Rest your arm as much as possible, and avoid any activities that cause pain.
- Begin applying cold compresses for 10-15 minutes at a time, multiple times per day.
- If the pain is severe, take ibuprofen or acetaminophen as recommended.
- If pain is particularly intolerable, you may have to make a homemade sling until you are able to meet with a physician.
Still have questions regarding tennis elbow or how Dr. Schwartz can assist you? Reach out to him directly today!