Tennis elbow

Tennis elbow

Description, Causes and Risk Factors:

Tennis elbow is a form of tendonitis that causes pain over the bony prominence called the lateral epicondyle on the outside of the elbow. About 5 in 1,000 adults develop tennis elbow each year. It mainly affects people between the ages of 35 and 55. Women and men are affected equally.

Tennis elbow is caused by repetitive stress on the muscles and tendons that are connected to the lateral epicondyle. These muscles extend along the top, or dorsal, side of the forearm to the wrist and are responsible for extending or bending back the wrist and fingers. The tendons are fibrous bands that connect the muscles to the bone, in this case the lateral epicondyle.

If too much stress is placed on these muscles and tendons, micro tears can occur at the site where the tendons attach to the lateral epicondyle. These micro tears cause pain that is usually localized at the lateral epicondyle but the pain can occasionally radiate down the forearm. Aging appears to make these tendons more prone to breakdown. Therefore, lateral epicondylitis is more common once we get in our fourth decade of life and beyond.

Any repetitive activity that places strain on the muscles of the forearm (particularly the outer muscles) can cause small tears to develop in the tendon fibres. These tears occur at the point where the tendon attaches to the bone and occasionally in the covering of the bone (the periosteum). The tears cause the tendons and muscles to become inflamed, producing pain. Activities that can cause to tennis elbow include:


  • Hammering (e.g., in carpentry).

  • Tennis (particularly the backhand swing).

  • Squash.

  • Bowling.

  • Painting.


Pain around the outer part of the elbow is the most typical symptom of tennis elbow. The pain is often described as "burning" in nature. The elbow may be painful to touch and the pain may radiate down the forearm. The pain often increases with grasping, gripping, or rotation of the wrist and forearm. Straightening and bending the elbow may also cause pain.

The severity of pain can range from a mild discomfort to severe pain that interferes with sleep. The pain tends to start gradually and worsen over a period of weeks or months.

When the condition is chronic (long-term), weakness of grip may be experienced.


No special tests are needed to makethe diagnosis. This diagnosis is madeby history and physician examinationof the patient. X-rays are not always required whenevaluating a patient with tennis elbowsymptoms, but a doctor may wishto orderthem just to make certainthat the bone structures of the elboware normal.


Like many overuse injuries of sport, there is no sure-fine treatment. Rest itself does not necessarily cure the problem, but it may decrease the pain and allows healing to progress. Decreased activity with the elbow and wrist is generally preferred over absolute rest and complete inactivity. The healing of tennis elbow can take weeks to months. Some physicians believe that the key to healing this overuse injury lies in increasing the circulation to the area while decreasing the tightness of the muscles. Therefore, stretching and strengthening exercises are frequently helpful.

The following exercise may help:

Support the forearm on a flat surface with the wrist and hand free. Hold a 1 to 2 pound weight in the hand. Keeping the palm down, slowly extend the wrist. Bring it backward, or up, and then bend it forward, or down. The muscles on the top of the forearm should contract when the wrist is moved upward and stretch when the hand is moved downward.

Nonsteroidal anti-inflammatory medications like aspirin, ibuprofen, and ketoprofen, or various prescription drugs can treat the symptoms and may decrease the pain and irritation in and around the tendon. However, it appears unlikely that these medications can actually evoke more rapid healing of the condition.

Icing the joint after activity may also decrease the irritation and relieve the pain.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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