Tennis Elbow

Tennis elbow is soreness or pain in the outer part of the elbow. It happens when you damage the tendons that connect the muscles of your forearm to your elbow. The pain may spread down your arm to your wrist. If you don’t treat the injury, it may hurt to do simple things like turn a key or open a door. Your doctor may call this condition lateral epicondylitis.

Most of the time, tennis elbow is caused by overuse. You probably got it from doing activities where you twist your arm over and over. This can stress the tendon, causing tiny tears that in time lead to pain and damage. A direct blow to the outer elbow can also cause tendon damage.

Tennis elbow is common in tennis players, but most people get it from other activities that work the same muscles, such as gardening, painting or using a screwdriver. It is often the result of using equipment that is the wrong size or using it the wrong way. Anyone can get tennis elbow, but it usually occurs in adults in their 40s.

To diagnose tennis elbow, a doctor will examine your elbow and ask questions about the problem, your daily activities and past injuries. You probably won’t need to have an X-ray, but you might have one to help rule out other things that could be causing the pain.

If your symptoms don’t get better with treatment, you might have an imaging test, such as an MRI. This can tell your doctor whether a bone problem or tissue damage is causing your symptoms.

Treatment can be done at home and can be started right away. To do so:

• Rest your arm, and avoid any activity that makes the pain worse.
• As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice as long as it relieves pain. Alternatively, use a warm, moist cloth or take hot baths if they feel good. Do what works for you.
• Take over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen if you need them. You may also try a NSAID cream that you rub over the sore area. Read and follow all instructions on medicine labels.
• Wear a counterforce brace when you need to grasp or twist something. This is a strap worn around your forearm just below the elbow. It may ease the pressure on the tendon and spread force throughout your arm.

After the pain eases, your doctor or physical therapist can teach you rehabilitation (rehab) exercises to stretch and strengthen your tendon. Doing these exercises at home can help your tendon heal and prevent further injury.

Once you feel better, you can return to your activity, but take it easy for a while. Don’t start at the same level as before your injury. Build back to your previous level slowly, and stop if it hurts. 

To avoid damaging your tendon again:

• Ask your doctor, a physical therapist or a trainer to check the way you are doing your activity. If the way you use a tool is the problem, try switching hands or changing your grip. Make sure you are using the right equipment for your size and strength.
• Always take time to warm up before and stretch after you exercise.
• After the activity, apply ice to prevent pain and swelling.
• Be patient, and stay with your treatment. You will probably feel better in a few weeks, but it may take six to 12 months for the tendon to heal. In some cases, the pain may last two years or longer.

If your symptoms don’t improve after six to eight weeks of home treatment, your doctor may suggest a corticosteroid injection. This could give you some short-term relief so you can start rehab exercises. But in the long term, the injection may not help any more than not having it. Surgery is seldom needed for tennis elbow.