Tennis elbow is a type of tendinitis -- swelling of the tendons -- that causes pain in the elbow and arm. These tendons are bands of tough tissue that connect the muscles of your lower arm to the bone. Despite its name, you can still get tennis elbow even if you've never been near a tennis court. Instead, any repetitive gripping activities, especially if they use the thumb and first two fingers, may contribute to tennis elbow. Tennis elbow is the most common reason that people see their doctors for elbow pain. It can pop up in people of any age, but it's most common at about age 40.
The Causes of Tennis Elbow
Tennis elbow usually develops over time. Repetitive motions -- like gripping a racket during a swing -- can strain the muscles and put too much stress on the tendons. That constant tugging can eventually cause microscopic tears in the tissue.
Tennis elbow might result from:
Tennis
Racquetball
Squash
Fencing
Weight lifting
It can also affect people with jobs or hobbies that require repetitive arm movements or gripping such as:
Carpentry
Typing
Painting
Raking
Knitting
Symptoms of Tennis Elbow
The symptoms of tennis elbow include pain and tenderness in the bony knob on the outside of your elbow. This knob is where the injured tendons connect to the bone. The pain may also radiate into the upper or lower arm. Although the damage is in the elbow, you're likely to hurt when doing things with your hands.
Tennis elbow may cause the most pain when you:
Lift something
Make a fist or grip an object, such as a tennis racket
Open a door or shake hands
Raise your hand or straighten your wrist
Tennis elbow is similar to another condition called golfer's elbow, which affects the tendons on the inside of the elbow.
To diagnose your tennis elbow, your doctor will do a thorough exam. They will want you to flex your arm, wrist, and elbow to see where it hurts. You may also need imaging tests, such as an X-ray or MRI (magnetic resonance imaging) to diagnose tennis elbow or rule out other problems.
Nonsurgical Treatment
Approximately 80% to 95% of patients have success with nonsurgical treatment.
Rest. The first step toward recovery is to give your arm proper rest. This means that you will have to stop participation in sports or heavy work activities for several weeks.
Non-steroidal anti-inflammatory medicines. Drugs like aspirin or ibuprofen reduce pain and swelling.
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Physical therapy. Specific exercises are helpful for strengthening the muscles of the forearm. Your therapist may also perform ultrasound, ice massage, or muscle-stimulating techniques to improve muscle healing.
Brace. Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce symptoms by resting the muscles and tendons.
Surgical Treatment
If your symptoms do not respond after 6 to 12 months of nonsurgical treatments, your doctor may recommend surgery.
Most surgical procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to bone.
The right surgical approach for you will depend on a range of factors. These include the scope of your injury, your general health, and your personal needs. Talk with your doctor about the options. Discuss the results your doctor has had, and any risks associated with each procedure.
F.A.S.T. Procedure. The innovative FAST procedure—Focused Aspiration of Scar Tissue—is based on advanced technology developed in collaboration with the Mayo Clinic. FAST is a minimally invasive procedure designed to remove tendon scar tissue quickly and safely, without disturbing your surrounding healthy tendon tissue.
Click here to watch the F.A.S.T procedure.
Arthroscopic surgery. Tennis elbow can also be repaired using tiny instruments and small incisions. Like open surgery, this is a same-day or outpatient procedure.
Surgical risks. As with any surgery, there are risks with tennis elbow surgery. The most common things to consider include:
Infection
Nerve and blood vessel damage
Possible prolonged rehabilitation
Loss of strength
Loss of flexibility
The need for further surgery
Rehabilitation. Following surgery, your arm may be immobilized temporarily with a splint. About 1 week later, the sutures and splint are removed.
After the splint is removed, exercises are started to stretch the elbow and restore flexibility. Light, gradual strengthening exercises are started about 2 months after surgery.
Your doctor will tell you when you can return to athletic activity. This is usually 4 to 6 months after surgery. Tennis elbow surgery is considered successful in 80% to 90% of patients. However, it is not uncommon to see a loss of strength.