Tennis Elbow Treatment in Delhi, India

Tennis elbow is a painful condition where the muscles around the elbow because inflammed and weak. It occurs when the elbow is under constant strain from repetitive movements.

Alternate Name of Tennis Elbow

Lateral Epicondylitis

Associated Anatomy

Tennis elbow affects the area where the forearm meets the elbow.

Tennis Elbow Causes

Tennis elbow can be caused by following activities/profession

• Muscle strain injury (Gym workouts)
• Repeated contraction of the forearm muscles
• Repeated movement and stress to the tissue
• A poor technique followed while playing tennis
• Using plumbing tools
• Cutting, chopping, and mincing food items
• Painting
• Driving screws
• Constant use of the computer mouse
• Working on vehicles
• Cutting trees

Tennis Elbow Symptoms

Signs and symptoms of tennis elbow include:

• Continuous pain on the outside of the elbow
• Pain shifts to the forearm and the wrist
• Pain is triggered by movements of the wrist
• Pain when the arm is not moving
• Inability to grip an object
• Pain while holding things like a cup
• Pain and weakness when shaking hands

Stages of Tennis Elbow

• Inflammatory changes that can be reversed.
• Irreparable changes to the ECRB (Extensor carpi radialis brevis) muscle.
• Rupturing of the ECRB muscle.
• Secondary changes, like fibrosis or calcification.

Tennis Elbow Diagnosis

Doctors diagnose tennis elbow by asking about symptoms and medical history. They check for pain in different parts of the arm. Doctors also ask you to perform simple movements, such as stretching the arm out and bending the wrist.

The diagnostic tests are:

• Electromyography helps the doctor understand if there is any issue with the nerves in the elbow and how quickly they send signals. It also measures electrical activity in the muscles.
• Magnetic Resonance Imaging (MRI) detects arthritis in the neck or any problem in the back.
• X-ray helps check for arthritis in the elbow.

Tennis Elbow Treatment

Doctors will ask you to discontinue your sports or activities to rest your arm. They will recommend physical therapy and the following treatment:

• Anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen.
• Ice massage followed by muscle stimulation.
• Corticosteroids to inject into the arm to bring down the swelling and the pain.
• A brace or a splint to rest the tendons and the muscles.
• Ultrasonic therapy to break scar tissue to encourage blood flow and healing.

Tennis Elbow Risk Factors

• Age: Tennis elbow is a common condition among adults in the 30-50 years age group
• Sports: Players of racket sports are at an increased risk if they employ poor playing technique
• Occupation: People doing jobs that require constant movements of the wrist and arm, such as painters, plumbers, cooks, carpenters, and butchers, are at a greater risk of developing tennis elbow.

Tennis Elbow Prevention

Primary Prevention

• Resting the elbow and the forearm and avoiding painful activity.
• Simple exercises to stretch and strengthen the wrist and forearm.
• Avoiding constant hand and arm movements.
• Using shoulder and upper arm muscles to remove the strain from the elbow.
• Warming up before a workout and sports activities.
• Keeping the wrist straight and not bending it while working.
• Avoiding jerky movements.
• Holding tools with a light grip to avoid straining the tendons.
• Practising correct playing techniques.
• Regular use of tennis elbow band for 2-3 months while working.
• Avoid lifting of weights more than 1-2 KG for 3 months.

Secondary Prevention

• Occupational or physical therapy: This helps in stretching and strengthening the forearm.
• Injections: Platelet-rich plasma or botox is injected into the painful tendon to relieve the pain.
• Ultrasonic tenotomy: Inserting a special needle through the skin into the damaged portion of the tendon to liquefy the damaged tissue and suction it out.
• Atheroscopic surgery: This procedure involves cutting the skin over the elbow and removing the damaged part of the tendon.

Possible Complication of Tennis Elbow

Surgery for tennis elbow may cause complications, such as infection, fever, severe pain, swelling, redness or a change in the colour of the skin around the elbow. There may also be damage to nerves and blood vessels, numbness and tingling in the fingers and hands, and drainage from the wound.

Epidemiology of Tennis Elbow

• Gender: Tennis elbow affects men and women equally.
• Age: It is common in people between 30 and 50.
• Sportspersons: 10% of tennis players suffer from tennis elbow.
• Lifestyle habits: People who are obese, smoke regularly, lift heavy weights, and indulge in vigorous activity develop tennis elbow.
• Recovery: 80 to 90% of patients recover from tennis elbow within one to two years.

Expected Prognosis of Tennis Elbow

Treatment consisting of ice, rest and anti-inflammatory medicines will help you get relief from the pain within 12 months. Physical and occupational therapies further help in recovering from the condition.

Natural Progression of Tennis Elbow

If left untreated, tennis elbow can become a chronic condition, especially if the repetitive activity is continued. Over time, a nerve could get entrapped in the forearm. This will cause pain and numbness in the fingers and the forearm. It could also lead to weakness in the hand.

Pathophysiology of Tennis Elbow

Tennis elbow leads to granulation tissue, micro rupture, vascular hyperplasia, fibroblasts, unstructured collagen, and lack of traditional inflammatory cells in the tissue. Calcification, intra-substance tears, marked irregularity of lateral epicondyle, and thickening and heterogeneity of the common extensor tendon are also observed through ultrasound evaluation.