Tennis Elbow

Tennis elbow is a painful disorder in which the muscles that connect your forearm muscles to your bones become weakened. It occurs when you overwork your elbow by repeatedly performing particular motions. Tennis elbow is a common condition that normally only requires little treatment, but healing takes time and relaxation.

Physicians also refer to this condition as lateral epicondylitis.

Symptoms usually appear gradually. Over weeks and months, the pain may worsen. The signs and symptoms that indicate tennis elbow are:

1. Recurring pain or burning sensation outside your outer elbow and forearm.
2. Pain while moving your arm
3. Stiffness in arm 
4. Weakened grip
5. Elbow joint is swollen
6. Pain may spread to the wrist even at rest 

When a player strikes a backhand stroke in tennis, they exert pressure on their forearm muscles, which contract when the ball is striked. This puts extra stress on the tendons that connect the forearm muscles to the elbow if the technique used by the athlete is wrong or if grip the racquet too tightly. This might lead to small tears in the tendons. 

Overuse is the most common basis of tennis elbow. Regular arm movements that might lead to tennis elbow due to their repetitive action are plumbing work, painting, cutting eating materials, specifically meat, long use of computer mouse, driving screws, carpentry work, working on cars, playing sports like squash and racquetball. 

Therefore, the tennis elbow is caused by:

1. Repetitive movement of arms
2. Tendinitis
3. Tendinosis
4. Tendon tearing caused due to both tendinitis and tendinosis

Aspects that may increase the risk of tennis elbow are:

1. Age: Although this condition can affect any age group, 30 – 50 years is among the most prevalent.
2. Occupation: Individuals who require repetitive motion at their work are at higher risks—E.g. Plumbers, carpenters, butchers etc.
3. Particular sports: Sports involving racquets increase the risk of tennis elbow, particularly if the wrong technique is employed.

Your physician will conduct a physical examination to look for swelling, stiffness or pain. You might also be asked about activities that cause pain. 

The physician will also recommend some tests for further diagnosis:

1. X-Rays: It is done to check for arthritis or any broken bone.
2. Imaging tests such as MRI, CT-Scan, and Ultrasound: It is done to assess tendon and muscle damage. 
3. Electromyography: To determine whether you have a problem with your elbow nerves and how well and quickly they convey signals. It can also detect electrical activity in your muscles when relaxed and contracted.

Tennis elbow can usually get healed on its own. However, some cases might require external help. Thus, based on your condition, the physician will recommend you the line of treatment. Nonsurgical treatment improves the condition of about 95% of persons with tennis elbow. Symptoms may take six to 18 months to disappear. Only a few people require surgery. Within a year, 80 per cent to 90 per cent of persons who have tennis elbow surgery report that their symptoms have improved.

Your doctor will initially recommend you some self-care measures such as:

1. Rest: The physician might ask you to stop or reduce the activities, so the condition heals.
2. Non-Steroidal Anti-inflammatory Drugs: Drugs such as ibuprofen and naproxen are prescribed to ease the pain.
3. Braces: your physician might suggest you wear an elbow brace to take off the strain from the tendons and muscles
4. Applying Ice for 15 minutes twice or thrice a day.

In case self-care measures don't heal, the doctor would then suggest a nonsurgical treatment which involves the following:

1. Physical therapy: Physical therapy exercises, massage, or other muscle stimulation techniques might aid in reducing pain and enhancing function.
2. Steroid injections: Corticosteroid injections are recommended to temporarily relieve pain and reduce inflammation.
3. Platelet-rich plasma (PRP) therapy involves the use of platelets, which are small cell fragments found in the blood that aid in healing. A small volume of blood is removed, and platelets are separated from other blood cells during a (PRP) therapy injection. The enriched platelets are then injected into the damaged area under ultrasound supervision.
4. Extracorporeal shock wave therapy: Scar tissue can be broken up with sound waves. Following that, blood flow to the injured area improves.
5. Ultrasonic tenotomy (TENEX procedure): A specific needle is inserted into the injured section of the tendon via skin under ultrasound guidance in this treatment by the surgeon. The needle vibrates so rapidly with ultrasonic energy that the damaged tissue softens and might be suctioned away.

However, if your symptoms persist after six to twelve months of non-operative therapy, you might require surgery to eliminate injured tendons. These treatments might be carried out by a single major incision or multiple tiny ones. It would help if you did not neglect the exercises recommended by your physician for quicker recovery.

The various benefits of treating tennis elbow are as follows:

1. Relief from uncontrollable pain and swelling
2. Regaining the strength to hold objects
3. Regaining the motion in the arms

Tennis elbow is a common condition and can be cured easily by self-care measures or nonsurgical techniques. However, if the condition is neglected, the pain might intensify and eventually require surgery.