Tennis elbow or lateral epicondylitis or epicondylalgia, is the most common type of elbow pain and contrary to its name is not caused just by playing tennis. Any type of repetitive strain such as a racquet sport, painting or using a hammer or lawn trimmer or other workplace strain can cause small tears in the tendons of the forearm, especially near where they attach to the outside of the elbow. This damage results in a range of symptoms from a dull ache at rest to pain with simple activities such as trying to use a doorknob or grasp an object.
A tight band often develops in the forearm and the outside bony knob of the elbow is often sore to press. Less commonly the tendons that are attached to the inside of the elbow are affected and this condition is then known as gopher’s elbow and results in similar symptoms. Poor strength or flexibility in the forearm can increase susceptibility to tennis elbow, as can poor sporting technique and the wrong sized grip on a tennis racquet (or golf club in the cases of gopher’s elbow). Neck problems are often associated with elbow pain as well, perhaps reflecting the impact that repetitive strain can have on the whole upper extremity, not just the forearm.
For sports related strain a review with the tennis coach (or golf pro) can correct technique problems and ensure the correct size grip is being used. Work tasks which strain the hands and forearms should be modified to reduce strain. For office workers posture and positioning should be reviewed and there are now vertical computer mice available which can unload the forearm, shoulder and neck and assist recovery. There is no single best treatment for tennis elbow, and a number of approaches are often combined.
Rest and ice are useful ‘first aid’ for an acutely painful episode and an elbow brace or taping sometimes offers relief. Painkillers may offer temporary relief but do not result in a long-term solution. Massage focusing on the forearm and sometimes the neck and upper back are a fundamental part of therapy. Acupuncture is invaluable to release tight muscle bands and promote circulation and healing of damaged muscles and tendons and is often supplemented with electro-stimulation or moxibustion, a traditional Chinese form of heat therapy. Exercises which gently strengthen the forearm can aid in recovery and prevent recurrence.
Repetitive strain injuries should not be ignored as they can impact on both recreation and work and can become chronic and debilitating. Identifying and addressing the early signs of strain often means that the problem can be resolved without needing professional care. When self-help isn’t enough though, prompt treatment is best.