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Tennis elbow

Tennis elbow is a common term for a condition caused by overuse of arm and forearm muscles that results in elbow pain. You don't have to play tennis to get this, but the term came into use because it can be a significant problem for some tennis players.

Tennis elbow is caused by either abrupt or subtle injury of the muscle and tendon area around the outside of the elbow. Tennis elbow specifically involves the area where the muscles and tendons of the forearm attach to the outside bony area (called the lateral epicondyle) of the elbow. Your doctor may call this condition lateral epicondylitis. Another common term, golfer's elbow, refers to the same process occurring on the inside of the elbow -- what your doctor may call medial epicondylitis. Overuse injury can also affect the back or posterior part of the elbow as well.

Tennis elbow most commonly affects people in their dominant arm (that is, a right-handed person would experience pain in the right arm), but it can also occur in the nondominant arm or both arms.

What are the symptoms of tennis elbow?

Symptoms of tennis elbow include:

  • Pain slowly increasing around the outside of the elbow. Less often, pain may develop suddenly.
  • Pain is worse when shaking hands or squeezing objects.
  • Pain is made worse by stabilising or moving the wrist with force. Examples include lifting, using tools, opening jars, or even handling simple utensils such as a toothbrush or knife and fork.

Who gets tennis elbow?

Tennis elbow affects around five in 1,000 adults in the UK and as many as 50% of tennis players during their careers. However, less than 5% of tennis elbow diagnoses are related to actually playing tennis.

Tennis elbow affects men more than women. It most often affects people between the ages of 30 and 50, although people of any age can be affected.

Although tennis elbow commonly affects tennis players, it also affects other athletes and people who participate in leisure or work activities that require repetitive arm, elbow and wrist movement. 

Tennis elbow might result from:

  • Tennis
  • Squash
  • Fencing

There have been reports of tennis elbow type injuries from playing active video games, such as the Wii, PlayStation and Xbox.

It can also affect people with jobs or hobbies that require repetitive arm movements or gripping such as:

  • Carpentry
  • Typing
  • Painting
  • Raking
  • Knitting
  • Cleaning
  • Road workers
  • Chefs and waiters.

How is tennis elbow diagnosed?

Tennis elbow cannot be diagnosed from blood tests and rarely by X-rays. Rather it is usually diagnosed by the description of pain you provide to your doctor and certain findings from a physical examination.

Your doctor may ask you to flex your arm, wrist and elbow to see where it hurts.  If your GP refers you to a clinic, such as a rheumatology or a specialist physiotherapy clinic then you may also need imaging tests, such as an X-ray or MRI (magnetic resonance imaging) to rule out other problems.

Since many other conditions can cause pain around the elbow, it is important that you seek medical advice so the correct diagnosis can be made. Then your doctor can prescribe the appropriate treatment.

Tennis elbow usually is successfully treated by medical means and only rarely requires surgery.

The type of treatment recommended for tennis elbow will depend on several factors including age, type of other medications being taken, overall health, medical history and severity of pain. The goals of treatment are to reduce pain or inflammation, promote healing and decrease stress and abuse of the injured elbow, and allow full use of the arm.

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