Tennis elbow, or lateral epicondylitis, is the most common injury in patients seeking medical attention for elbow pain. Exactly what causes tennis elbow is unknown, but it is thought to be due to small tears of the tendons that attach forearm muscles to the arm bone at the elbow joint.
Tennis elbow occurs when there is a problem with the tendons that attach to the outside of the elbow. These tendons are the attachment of the muscles that function to cock the wrist back. Specifically, the extensor carpi radialis brevis has been implicated in causing the symptoms of tennis elbow. This muscle attaches to a part of the elbow bone called the lateral epicondyle, thus giving tennis elbow the medical name 'lateral epicondylitis.'
Tennis elbow is not simply an "inflammation" of these tendons. The problem is thought to be a degenerative process as a result of repetitive use. This process occurs when microscopic tears are incompletely healed within the tendon.
Tennis elbow is most commonly seen in two groups of people:
- Manual Laborers
People who work with their hands are at greater risk of developing tennis elbow. Jobs that may lead to tennis elbow include plumbers, painters, gardeners, and carpenters.
- Sports Participants
Sports participants, especially racquet sport players, are prone to developing tennis elbow. About a third of amateur tennis players experience tennis elbow at some point in their careers. In addition to racquet sports, tennis elbow is seen in golfers, fencers, and other sports participants.
Patients with tennis elbow experience pain on the outside of the elbow that is worsened by grasping objects and cocking back the wrist. The most common symptoms of tennis elbow are:
- Pain over the outside of the elbow
- Pain when lifting objects
- Pain radiating down the forearm
The pain associated with tennis elbow usually has a gradual onset, but it may also come on suddenly. Most patients with tennis elbow are between the ages of 35 and 65 years old, and it affects about an equal number of men and women. Tennis elbow occurs in the dominant arm in about 75 percent of people.
When To Seek Treatment
The following symptoms should be discussed with your doctor:
- Inability to carry objects or use your arm
- Elbow pain that occurs at night or while resting
- Elbow pain that persists beyond a few days
- Inability to straighten or flex your arm
- Swelling or significant bruising around the joint or arm
- Any other unusual symptoms
Treatment of tennis elbow always begins with simple steps. It is usually best to begin treatments in a stepwise fashion, advancing to the next treatment only if one fails to alleviate your symptoms. It is also important to remember that most patients take a few months from the onset of symptoms to resolution of symptoms -- it is rarely an overnight cure. Most all individuals will respond to chiropractic manipulation and physical therapy, which is the most important part of the treatment. It includes various modalities for treating and preventing tennis elbow.