What You Need to Know About Tennis Elbow and Its Treatment

by | Nov 18, 2024 | Injury Prevention, Rehabilitation

Tennis elbow (or lateral epicondylitis) is a condition where you feel pain on the outer side of your elbow. It happens because the tendons that connect your forearm muscles to the outside of your elbow get overused or strained. You’ll usually feel it when you try to lift, grip, or twist something, and it can even make everyday tasks, like turning a doorknob or holding a coffee cup, more painful.

Anyone who performs similar repetitive arm movements can get it. Think about people who paint, do carpentry, or even those who spend a lot of time at a computer.

What Causes Tennis Elbow?

  • Repetitive Motion: When you do something that requires a lot of wrist extension (something as simple as typing on the computer), it stresses the tendons and muscles in the forearm that attach to the elbow. Over time, this repetitive motion can cause tiny tears in the tendons, leading to inflammation and pain.
  • Overuse: Doing the same thing repeatedly without proper rest—like lifting weights, typing, or even too much gardening—can put a lot of strain on your elbow and lead to injury.
  • Age: It’s more common in people between 30 and 50 years old because the tendons lose some of their elasticity and ability to heal as you get older.
  • Incorrect Form or Equipment: Whether it’s playing sports like tennis or badminton, or doing your regular work, poor form or the wrong equipment can put unnecessary stress on your elbow. For example, if the equipment you’re using is too heavy or too large for you, or if you’re using improper technique, it can increase your risk of tennis elbow.

What Does Tennis Elbow Feel Like?

Tennis elbow pain isn’t always obvious at first—it often comes on gradually. Here’s what you might notice:

  • Pain on the Outside of the Elbow: You’ll feel a dull ache or sharp pain on the outer part of your elbow, and it can sometimes radiate down to your forearm.
  • Pain with Activity: The pain tends to get worse when you perform activities that involve gripping or twisting—like using a screwdriver, shaking hands, or holding a heavy bag.
  • Weakness: You might also notice your grip strength is weaker, making it harder to do tasks like opening jars or holding onto objects.
  • Tenderness: The outer part of your elbow might be sore to the touch, especially around the bony lump (called the lateral epicondyle).

Treatment Options for Tennis Elbow

Fortunately, most people recover from tennis elbow with non-surgical treatments. Here’s a more detailed breakdown of what you can do:

1. Rest and Activity Modification

  • The first step is to give your elbow a break. This means avoiding the activities that caused or are aggravating the pain. For some, it’s hard to completely stop, so try to reduce the frequency and intensity of activities like working, lifting, or repetitive arm motions.
  • Modify your daily activities: For example, try to use your non-dominant arm more, or use tools that don’t strain your elbow as much (e.g., lightweight or ergonomic tools).

2. Ice and Heat Therapy

  • Ice: For the first 48 hours after you start feeling pain, apply an ice pack wrapped in a cloth to the outside of your elbow. Do this for 15-20 minutes, several times a day. Ice helps reduce inflammation and numb the pain.
  • Heat: After the initial inflammation goes down, you can switch to heat therapy (like a warm towel or heating pad) to relax the muscles and improve blood circulation. But avoid heat if you’re still feeling a lot of swelling or acute pain.

3. Pain Relief and Anti-Inflammatory Medications

  • NSAIDs like ibuprofen or naproxen can help reduce inflammation and relieve pain. Acetaminophen (Tylenol) is a good option for pain relief if you can’t take NSAIDs, but it won’t reduce swelling.
  • Topical creams or gels with pain-relieving properties (like those containing menthol or capsaicin) can also be applied directly to the elbow for localized relief.

4. Bracing or Splinting

A counterforce brace (a band worn on your forearm, just below the elbow) can reduce strain on the affected tendon. It works by redistributing the forces going through the elbow, allowing the tendons to rest.

Sometimes, an elbow splint can also be recommended if the elbow is extremely stiff or painful.

5. Physical Therapy

  • A physical therapist can guide you through exercises to stretch and strengthen the muscles around your elbow. This can help improve flexibility and strength in the forearm muscles, reducing the stress on the tendons.
  • Eccentric exercises (where you slowly lengthen the muscle while it’s under tension) are particularly effective for tendon healing.
  • Your therapist may also use techniques like manual therapy (hands-on methods) or needling (dry needling or acupuncture) to help with healing and pain relief.

6. Corticosteroid Injections

If the pain is severe and persistent, and other treatments haven’t worked, your doctor might suggest a corticosteroid injection. These can significantly reduce inflammation and provide pain relief for several weeks or months. However, while effective for short-term relief, these injections don’t address the underlying tendon damage and shouldn’t be overused.

7. Platelet-Rich Plasma (PRP) Injections

PRP therapy is becoming more popular, though it’s not yet a standard treatment. It involves drawing blood from your body, concentrating the platelets (which help with healing), and then injecting that concentrated plasma back into the elbow. It’s believed to stimulate healing in the damaged tendons. While it’s not guaranteed to work for everyone, some patients experience significant improvement

8. Surgery (Last Resort)

Surgery is rarely necessary and is only considered after all conservative treatments fail. The procedure usually involves removing damaged tissue from the tendon or repairing tears. Recovery time after surgery can be lengthy, so it’s typically a last resort after other options have been exhausted.

9. Prevention

Technique and Equipment: Whether you’re playing sports or participating in other activities, make sure you’re using the proper technique. In sports, working with a coach can do a great job in helping to correct poor form.

Stretching and Strengthening: Make stretching a part of your warm-up routine before any activity. Also, strengthening your forearm muscles with specific exercises can help make your tendons more resilient to strain.

How Long Does Recovery Take?

  • Most people start feeling relief within a few weeks, but full recovery can take anywhere from 6 weeks to 6 months depending on the severity.
  • If you continue to push through pain without resting or giving your elbow enough recovery time, it could lead to chronic symptoms that are harder to treat.
  • If things don’t improve within a few months, it’s a good idea to see a doctor or specialist, as they can offer additional treatment options.