Tennis elbow (lateral epicondylitis) is a painful condition caused by injury to the tendons that attach the forearm muscles to the outer part of the elbow due to repetitive strain. While the name implies a link to sports, tennis elbow isn’t exclusive to athletes. It is commonly seen in people whose jobs involve repetitive use of the forearm muscles.
Professions at higher risk include carpenters, painters, plumbers, artists, and individuals who frequently use a keyboard and mouse.
Symptoms of Tennis Elbow
Tennis elbow symptoms typically develop gradually. Initially, pain is felt only during activity, but in advanced cases, discomfort can also occur during rest.
Common symptoms include:
- Pain and tenderness on the outer part of the elbow, sometimes radiating into the forearm
- Weak grip strength
- Nighttime pain
- Increased pain during activities that stress the tendons (e.g., turning a doorknob, opening a jar, shaking hands, or holding small objects)
Tennis Elbow Treatment Options
Treatment is divided into non-surgical and surgical approaches. Based on the severity of the symptoms and the individual’s needs, a healthcare provider determines the most suitable treatment plan. Although surgery is an option, 80–95% of cases recover with non-surgical methods.
Non-Surgical Treatments for Tennis Elbow
1. Activity Modification and Rest
The first step in treatment is resting the affected arm to allow healing. Your doctor will recommend how long to rest and which activities to avoid or reduce.
2. Tennis Elbow Brace
Wearing a tennis elbow brace helps reduce strain on the injured tendons, promotes healing, and provides stability to prevent the condition from worsening.
3. Physical Therapy and Exercises
Manual therapy and specific tennis elbow exercises are essential components of rehabilitation. These methods increase flexibility, strength, and circulation in the elbow region, speeding up recovery.
4. Medications
Anti-inflammatory and pain-relief medications are commonly prescribed to reduce swelling and discomfort.
5. Cortisone Injections
Cortisone, a steroid that reduces inflammation, can be injected into the affected area. However, repeated use may weaken tissue, so post-injection activity should be carefully managed.
6. Platelet-Rich Plasma (PRP) Therapy
PRP involves injecting healing factors derived from the patient’s own blood into the injured area under ultrasound guidance. Unlike cortisone, PRP helps regenerate tissue.
7. Extracorporeal Shockwave Therapy (ESWT)
This non-invasive treatment sends high-energy shockwaves to the elbow to relieve pain, improve blood flow, and accelerate tendon healing.
Physical Therapy for Tennis Elbow
Manual therapy, which involves hands-on techniques, is commonly used to reduce pain and improve joint mobility. It enhances range of motion and reduces symptoms like numbness and stiffness.
In addition, electrotherapy can be integrated into the treatment plan to stimulate healing. Currents are applied around the elbow based on the patient’s needs.
A structured exercise program is crucial for recovery. It should include:
- Stretching exercises
- Strengthening exercises
- Range of motion exercises
These movements strengthen the forearm muscles and improve circulation, supporting the healing process. Consistency is key for long-term benefits.
Surgical Options for Tennis Elbow
If symptoms persist for more than six months and do not improve with non-surgical treatments, surgery may be recommended.
Goals of Surgery:
- Remove damaged tendon tissue
- Reattach the healthy portion of the tendon to the bone
There are two types of surgery:
- Open surgery
- Arthroscopic (minimally invasive) surgery
The choice depends on the patient’s overall health, severity of symptoms, and treatment goals. Your doctor will determine the most suitable option based on a detailed evaluation.