Tennis Elbow

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Topic Overview

What is tennis elbow?

Tennis elbow is soreness or pain on the outer part of the elbow. It happens when you damage the tendons that connect the muscles of your forearm to your elbow. The pain may spread down your arm to your wrist. If you don't treat the injury, it may hurt to do simple things like turn a key or open a door.

See a picture of tennis elbow . Your doctor may call it lateral epicondylitis.

What causes tennis elbow?

Most of the time tennis elbow is caused by overuse. You probably got it from doing activities where you twist your arm over and over. This can stress the tendon, causing tiny tears that in time lead to pain. A direct blow to the outer elbow can also cause tendon damage.

Tennis elbow is common in tennis players, but most people get it from other activities that work the same muscles, such as gardening, painting, or using a screwdriver. It is often the result of using equipment that is the wrong size or using it the wrong way. For example, a tennis racquet with a grip too large for your hand can lead to tendon damage.

Anyone can get tennis elbow, but it usually occurs in adults between the ages of 40 and 60.

How is tennis elbow diagnosed?

To diagnose tennis elbow, a doctor will examine your elbow and ask questions about the elbow problem, your daily activities, and past injuries. You probably won't need to have an X-ray, but you might have one to help rule out other things that could be causing the pain.

If your symptoms don't get better with treatment, you might have an imaging test, such as an MRI. This can tell your doctor whether a bone problem or tissue damage is causing your symptoms.

How is it treated?

You can start treating tennis elbow at home right away.

• Rest your arm, and avoid any activity that makes the pain worse.
• Apply ice or cold packs for 10 to 15 minutes at a time, up to 2 times an hour, for the first 3 days. Keep using ice as long as it helps.
• Take over-the-counter pain relievers such as ibuprofen or naproxen (NSAIDs) or acetaminophen if you need them.
• Wear a "counterforce" brace when you need to grasp or twist something. This is a strap around your forearm placed about an inch below your elbow. It eases the pressure on the tendon and spreads force throughout your arm.

After the pain eases, your doctor or physical therapist can teach you rehab exercises to stretch and strengthen your tendon. Doing these exercises at home can help your tendon heal and can prevent further injury.

When you feel better, you can return to your activity, but take it easy for a while. Don't start at the same level as before your injury. Build back to your previous level slowly, and stop if it hurts. To avoid damaging your tendon again:

• Take lessons or ask a trainer or pro to check the way you are doing your activity. If the way you use a tool is the problem, try switching hands or changing your grip. Make sure you are using the right equipment for your size and strength.
• Always take time to warm up before and stretch after you exercise.
• After the activity, apply ice to prevent pain and swelling.

Be patient, and stick with your treatment. You will probably feel better in a few weeks, but it may take 6 to 12 months for the tendon to heal. In some cases, the pain lasts for 2 years or longer.

If your symptoms don't improve after 6 to 8 weeks of home treatment, your doctor may suggest a shot of steroid medicine. This could give you some short-term relief so you can start rehab exercises. Surgery is seldom needed for tennis elbow.

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Last updated:	February 14, 2007
Author:	Monica Rhodes
Reviewed By:	Martin Gabica, MD - Family Medicine, David Pichora, MD, FRCSC - Orthopedic Surgery
Editors:	Kathleen M. Ariss, MS, Pat Truman