Tennis elbow (medically referred to as lateral epicondylitis) is an overuse injury of the elbow. According to the American Academy of Orthopedic Surgeons, people who suffer from tennis elbow do not have to receive the injury as a result of playing tennis. Many activities and sports can cause people to develop tennis elbow.
Tennis elbow can occur if a tendon joining the forearm muscles on the outside of the elbow becomes frayed or torn from a single heavy load or from repetitive trauma. The tendon typically affected is the extensor carpi radialis brevis, which functions to move the wrist backward while running between the hand and the lateral epicondyle (the bony bump on the outer side of the elbow).
Risk
People with a higher risk of developing tennis elbow include:
- Athletes
- People who work in occupations that require repetitive movements or lifting heavy weights, such as carpenters, plumbers, painters, cooks and auto workers
- People over the age of 40
- People who are taking certain types of medications, such as fluoroquinolone antibiotics (ciprofloxacin, levofloxacin) or aromatase inhibitors, such as those used in breast cancer treatment
- People who have a high-fat diet and have higher blood fat levels
People with no risk factors can also develop tennis elbow due to trauma, overuse or unknown causes.
Symptoms
Tennis elbow can cause tenderness and pain on the outside of the elbow, making it hard to use your arm, wrist and fingers. It can result in weak grip strength and a burning sensation on the outside of the elbow, especially during gripping or lifting with an outstretched arm.
Diagnosis
If you think you may have tennis elbow, visit your primary care provider or a sports medicine urgent care provider. Your provider will ask how and when your symptoms developed, whether you have any risk factors and if you participate in sports. They may also conduct a physical exam.
During the exam, your provider will apply pressure to your elbow to check for tenderness and pain. They may also ask you to bend your wrist and fingers while holding your arm straight to determine if you experience discomfort. Additionally, your provider may order an X-ray, MRI or electromyography scan to analyze the electrical activity in your muscles.
Treatment
If you are diagnosed with tennis elbow, your provider will advise you on activities you should avoid and recommend steps for recovery. It is important to rest your arm and follow your provider’s instructions to minimize pain and prevent worsening symptoms. Most cases are mild but can progress if untreated.
To manage swelling or pain, you can take acetaminophen or ibuprofen. Applying ice helps a lot.
If necessary, your provider may refer you for physical or occupational therapy to stretch and strengthen your forearm muscles through targeted exercises and activities.
Wearing a brace to stabilize your forearm and rest your tendons and muscles may help reduce symptoms. Steroid injections can also be used to decrease inflammation; however, they should be used sparingly, as they could weaken the tendon near the lateral epicondyle.
Some patients may benefit from a platelet-rich plasma (PRP) injection, which involves extracting a small blood sample, isolating the platelets and injecting them back into the arm to promote healing.
Most patients recover within six months to a year. In rare cases, if symptoms persist beyond a year despite treatment, surgery may be necessary. Surgery typically involves removing damaged tendon tissue and reattaching the healthy portion to the bone. Arthroscopic approach may lead to a quicker recovery. Fortunately, most tennis elbow surgeries are outpatient procedures, allowing you to go home the same day.
While 80–90% of patients have successful outcomes after surgery, risks can include:
- The need for further surgery
- Reduced flexibility or strength
- A possible need for rehabilitation
- Blood vessel or nerve damage
- Infection
After surgery, your arm may be placed in a splint for about a week. Physical therapy or rehabilitation to restore flexibility usually begins around six weeks after surgery. Full recovery can take four to six months.
Can I Prevent Tennis Elbow?
You can lower your risk of developing tennis elbow by:
- Using proper, well-fitting equipment for sports involving your arms, such as in tennis
- Warming up before exercise or sports activities
- Daily stretch exercises
- Gradually increasing the intensity of activities
- Strengthening your arm muscles
UofL Health Can Help
UofL Health – Kleinert Kutz Hand Care is at the forefront of pioneering treatments and comprehensive care for various hand and arm conditions. Our dedicated team of specialists includes world-renowned hand surgeons, therapists and support staff committed to delivering the highest level of care. To schedule an appointment with Kleinert Kutz Hand Care, call 502-561-4263.
UofL Health – Sports Medicine has primary care physicians and athletic trainers who have specialty certification in sports medicine, which gives them unique knowledge to address a wide variety of health conditions and prevention for athletes. Click here to see all our Sports Medicine locations.
Our UofL Health – Sports Medicine Performance Enhancement program is designed to offer weekend warriors and high school athletes the best performance enhancement and recovery services using the latest innovative technology, advanced techniques and evidence-based research. To learn more, call 502-637-9313.
UofL Health now offers two locations for better patient convenience at its specialized after-hours Sports Medicine Urgent Care clinics:
- East Louisville at UofL Health – Medical Center Northeast: 502-210-4602
- South Louisville at the new UofL Health – Medical Center Southend: 502-588-4814
No appointment is necessary at these walk-in clinics specializing in after-hours care of sports and orthopedic injuries. Our board-certified sports medicine physicians and advanced practice clinicians are on standby to treat a wide variety of injuries and illnesses.
