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WHAT IS TENNIS ELBOW?

Tennis elbow is a very common condition, which affects the elbow joint.
All the muscles which straighten or extend the fingers and the wrist join together and form a common tendon. This tendon is attached to the lower end of the arm bone (humerus) on the outer aspect. Any cause of inflammation of this region causes pain and is known as a tennis elbow.

 

WHAT IS THE CAUSE OF TENNIS ELBOW?

Any repetitive activity which involves wrist turning or hand gripping, can lead to this condition. Although it is common in tennis players it also affects people in other professions like manual workers, carpenters and gardeners. Direct injury to the area of the attachment of the tendon can also cause these symptoms.
WHAT ARE THE SYMPTOMS?

Patients experience pain that is localised to the outer side of the elbow joint. This pain often moves into the forearm and also into the upper arm. Gripping or lifting can aggravate the pain. As the condition progresses the pain can be fairly severe and cause loss of movement at the elbow joint. The most common loss is the inability to straighten the elbow completely.


HOW IS THIS DIAGNOSED?

The diagnosis is often made by a history and examination. Pressing directly onto the region of the attachment of the tendon will cause pain and confirm the diagnosis. Resisted straightening of the fingers or wrist also will reproduce the symptoms. It is possible that occasionally an x-ray will be indicated to see if there is any deposition of calcium in the region of this tendon. MRI Scans are very rarely needed.


WHAT IS THE TREATMENT?

The first line of treatment is to avoid activites which make the symptoms worse. This also gives time for the inflamed tendon to rest and therefore heal itself. Often local anaesthetic and steroid is injected into the inflamed tendon. Following this physiotherapy including local treatments, tissue mobilisation and stretching exercises are started. It is also important to apply ice on a regular basis to try and decrease the inflammation. Wearing a splint is useful in certain cases.

Surgery is only considered after an extended period of conservative management. This involves releasing the tendons from their attachment to the bone and removing abnormal tissue. This does not lead to any long term weakening of the arm.