ELBOW TENDINITIS OR EPICONDYLITIS (Tennis Elbow) |
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General Information
DEFINITION--Inflammation of muscles, tendons, bursa, or covering to bones (periosteum) at the elbow.
BODY PARTS INVOLVEDElbow muscles, tendons and one or both of the epicondyles (bony prominences on the sides of the elbow where muscles of the forearm attach to the bone of the upper arm).
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SIGNS & SYMPTOMS
Pain and tenderness over the epicondyles. Pain worsens with gripping or rotation of the forearm.
Weak grip.
Pain when twisting the hand and arm, as when playing tennis, throwing a ball with a twist, bowling, golfing, pushing off while skiing or using a screwdriver.
CAUSESPartial tear of the tendon and attached covering of the bone caused by:
Chronic stress on the tissues that attach the forearm muscles to the elbow area.
Sudden stress on the forearm.
Wrist snap when serving balls in racket sports.
Incorrect grip.
Incorrect hitting position.
Using a racket or club that is too heavy.
Using an oversize grip.
RISK INCREASES WITH
Participation in sports that require strenuous forearm movement, such as tennis and racquetball.
Poor conditioning of forearm muscles prior to vigorous exercise.
Inadequate warmup before competing.
Returning to activity before healing is complete.
HOW TO PREVENT
Don't play sports, such as tennis, for long periods until your forearm muscles are strong and limber. Take frequent rest periods.
Do forearm conditioning exercises to build your strength gradually.
Warm up slowly and completely before participating in sports--especially before competition.
Get lessons from a professional if you are a novice.
Use a tennis-elbow strap when you resume normal activity after treatment.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Self-care after diagnosis.
Doctor's treatment.
Physical therapy.
Surgery (rare).
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the elbow.
POSSIBLE COMPLICATIONS
Complete ligament tear, requiring surgery to repair.
Slow healing.
Frequent recurrences.
PROBABLE OUTCOMETennis elbow usually heals with heat treatments, corticosteroid injections and rest of the elbow. Treatment may require 3 to 6 months.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDNone. This problem develops slowly.
CONTINUING CARE
Use heat to relieve pain. Use warm soaks, a heating pad or a heat lamp. You may receive diathermy or ultrasound (See Glossary), whirlpool or massage treatments in your doctor's office or a physical-therapy facility. These may bring quicker symptom relief and healing.
You may need to wear a forearm splint to immobilize the elbow.
MEDICATIONYour doctor may prescribe:
Non-steroidal anti-inflammatory drugs to reduce inflammation.
Injections of anesthetics to temporarily relieve pain.
Injections of corticosteroids to reduce inflammation. CAUTION: Repeated injections may weaken the muscle tendon.
ACTIVITYDon't repeat the activity that caused tennis elbow until symptoms disappear. Then resume your normal activities gradually after proper conditioning.
DIETDuring recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs.
REHABILITATION
Do the following exercise 3 or 4 times a day while wearing the splint: Stretch your arm, flex your wrist, then press the back of your hand against a wall. Hold for 1 minute.
See section on rehabilitation exercises. Begin rehabilitation after pain disappears.
CALL YOUR DOCTOR IF
You have symptoms of tennis elbow.
Symptoms don't improve in 2 weeks, despite treatment.
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