Tennis elbow may present with pain that would radiate from outside of the elbow to the forearm and wrist. Pain would make movement of the hand difficult. Individuals with tennis elbow would also find it difficult to hold a cup, shake hands and turn a door knob. Without treatment, the pain gradually worsens and affected individuals also slowly lose the power to grasp.

Individuals who have developed tennis elbow would also experience morning stiffness in the area affected and pain from activities that utilize muscles of the affected area. Activities such as lifting and wrist extension would be painful for affected individuals.

• Pain

  Faint pain a couple of hours after the provoking activity. 2. Pain at the end of or immediately after the provoking activity. 3. Pain during the provoking activity, which intensifies after ceasing that activity. 4. [physio-pedia.com]

  Recently, we demonstrated vascularity in the extensor origin in patients with chronic painful tennis elbow, but not in controls with pain-free elbows. [ncbi.nlm.nih.gov]

  and lifting movementsSymptoms associated with tennis elbow include, but are not limited to, radiating pain from the outside of the elbow to the forearm and wrist, pain during extension of wrist, weakness of the forearm, a painful grip while shaking [en.wikipedia.org]

  When overused, the tendon can degenerate and cause pain in the area. It is particularly painful in patients who must do repeated wrist extension activities. [ucsfhealth.org]

  Patients with LUCL injuries will have pain and the sensation of instability when the elbow is extended, and the forearm is supinated. [rheumatologyadvisor.com]

• Inflammation

  Ice and compression may also help reduce inflammation and pain. Once inflammation subsides, you can begin gentle exercises to strengthen the muscles of the forearm and prevent recurrence. [healthline.com]

  Local instillation of corticosteroid depot in order to control inflammation (enthesitis) and thus, eliminate pain and establish physiological conditions for functioning of joint and local structures. [ncbi.nlm.nih.gov]

  This causes chronic inflammation on the outer side of the elbow, with pain that may radiate down the forearm and wrist. [stack.com]

  Calcific epicondylitis.jpg 500 × 654; 29 KB Cortisone injection for tennis elbow.jpg 888 × 654; 83 KB Counterforce brace YM.jpg 1 024 × 768; 261 KB Epicondylitis.jpg 802 × 716; 50 KB Inflammation of a forearm extensor muscle.jpg 1 920 × 1 080; 445 KB [commons.wikimedia.org]

• Swelling

  In addition to pain, you may have swelling around your elbow joint. Causes What causes tennis elbow? Overuse causes most cases of tennis elbow. It occurs when repeated movements cause swelling and pain in your joint and tendons. [familydoctor.org]

  Ice helps prevent tissue damage and decreases swelling and pain. Elevate your elbow above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your elbow on pillows or blankets to keep it elevated comfortably. [drugs.com]

  While there can be swelling, that's not always the case. "And usually there is no specific injury that a patient can relate the onset of symptoms to," she says. [fitnessmagazine.com]

  However, you may not have any swelling if your injury is minor. On the other hand, major swelling in the area may indicate a worse injury, such as a break or tear. [4] Visit your doctor if you have a lot of swelling. [wikihow.com]

• Weakness

  Because botulinum toxin injection did not relieve pain significantly but is associated with weakness, the muscle weakness caused by botulinum toxin is unlikely to be the sole mechanism of the pain relief observed in previous studies. [ncbi.nlm.nih.gov]

  Forearm pain may accompany weakness when the extensor muscles are contracted significantly because the sensory fibers in the affected muscles are being stimulated. [massagetoday.com]

  Provides moderate support for weak or injured elbow and forearm For injuries like tennis or golfer’s elbow Adjustable hook-and-loop strap for a quick, customizable fit Air cushion applies targeted compression Breathable materials allow air to circulate [acebrand.com]

  At least patients report weakness in their grip strength or difficulty carrying objects in their hand, especially with the elbow extended. This weakness is due to finger extensor and supinator weakness. [physio-pedia.com]

• Surgical Procedure

  The results of arthroscopic surgical procedures have documented satisfactory results, with improvement rates reported between 91% and 97.7%. [ncbi.nlm.nih.gov]

  However, this therapy is still considered experimental by many physicians; even though research has shown that it may be effective Surgical treatment: Arthroscopy of elbow joint : Arthroscopic surgery is a minimally-invasive surgical procedure that helps [dovemed.com]

  Surgical procedures and cortisone shots present risks and expense to patients. [tennis-elbow.com]

• Abdominal Pain

  Investigators reported that oral NSAIDs significantly increased the risk of developing abdominal pain (RR 3.17, 95% CI 1.35 to 7.41) and diarrhoea (RR 1.92, 95% CI 1.08 to 3.41). [doi.org]

• Skin Rash

  One participant in each group developed a mild and transient skin rash, but in neither case was it necessary to discontinue treatment. [doi.org]

• Elbow Pain

  Abstract Tennis elbow (Epicondylitis humeri radialis) is the most frequent reason that patients with elbow pain report to a physician. The exact cause of elbow pain is still unclear. [ncbi.nlm.nih.gov]

  Participants: 32 affected elbows (median and range of duration: 10; 3–120 months) and 18 unaffected contralateral elbows in 25 patients (mean age 50 years) with lateral elbow pain, and 38 unaffected elbows in 19 asymptomatic participants (mean age 45 [doi.org]

• Muscle Weakness

  Because botulinum toxin injection did not relieve pain significantly but is associated with weakness, the muscle weakness caused by botulinum toxin is unlikely to be the sole mechanism of the pain relief observed in previous studies. [ncbi.nlm.nih.gov]

  Sometimes the weakness is in the muscles of the wrist and forearm. In many cases, the problem stems from weakness of the supporting postural, or "core," muscles. [moveforwardpt.com]

  Forearm pain may accompany weakness when the extensor muscles are contracted significantly because the sensory fibers in the affected muscles are being stimulated. [massagetoday.com]

  An associated ulnar neuropathy may cause decreased sensation and/or a tingling sensation in the 4th and 5th fingers and, in more severe cases, muscle weakness in the hand. Enquire about activities which may have caused the tendinopathy. [patient.info]

• Wrist Pain

  When overused, the tendon can degenerate and cause pain in the area. It is particularly painful in patients who must do repeated wrist extension activities. [ucsfhealth.org]

  The unholy relationship between Perfect Spot No. 5, wrist pain and carpal tunnel syndrome Virtually all wrist pain is either caused or significantly complicated by myofascial TrPs in the forearm musculature, especially the extensors of the wrist and fingers [painscience.com]

  The pain of tennis elbow occurs primarily where the tendons of your forearm muscles attach to a bony bump on the outside of your elbow. Pain can also spread into your forearm and wrist. [mayoclinic.org]

  Tennis elbow may present with pain that would radiate from outside of the elbow to the forearm and wrist. Pain would make movement of the hand difficult. [symptoma.com]

• Osteophyte

  Concomitant intra-articular lesions (eg, loose bodies, synovitis, ulnohumeral osteophytes, chondral lesions) have been visualized during elbow arthroscopy in patients with lateral epicondylitis. [emedicine.com]

• Elbow Swelling

  Overview What is tennis elbow? Tennis elbow is another name for lateral epicondylitis. It occurs when the tendons that attach the muscle to the bone on the outside part of the elbow swell or tear. [familydoctor.org]

  Symptoms of Tennis Elbow & Diagnosis Symptom of tennis elbow commonly include: ( 10 ) Pain, tenderness and swelling around the elbow. [draxe.com]

• Irritability

  The muscle which is usually the most irritated (the extensor carpi radialis brevis) bends the elbow and pulls the wrist back. [eatonhand.com]

  Unlike conservative method which includes initial immobilization due to irritation and inflammation development prevention with concomitant analgesic and antirheumatic therapy, initial application of manipulation with reinstatement of joint mobility instead [ncbi.nlm.nih.gov]

  Other possible causes include the development of scar-like tissue under the tendon, wear and tear of the elbow joint, or irritation and inflammation of nerves that pass near the elbow region. [ccohs.ca]

  It occurs when the tissues that attach muscle to bone are overworked and become irritated. Symptoms include pain on the outside of your elbow, often extending down the forearm. [mhealth.org]

  Over time, this leads to irritation and pain where the tendon is attached to the bone." Joseph Brence, a physical therapist, educator and researcher from Pittsburgh, PA treats lots of older patients with tennis elbow. [huffingtonpost.ca]

• Confusion

  For the minority of people with lateral epicondylitis who do not respond to nonoperative treatment, surgical intervention is an option, but confusion exists because of the plethora of options. [ncbi.nlm.nih.gov]

  The symptoms of these conditions are usually distinct, but in some cases they can be confusing. These conditions should be considered if the symptoms are not typical for tennis elbow or if the patient does not respond to treatment. [orthopedics.about.com]

  Other pathology about the elbow can be confused with tennis elbow syndrome, including pressure on the radial nerve in the region of the elbow (radial tunnel syndrome), instability of the elbow, or arthritis of the elbow. [indianahandtoshoulder.com]

  Radial tunnel syndrome is an unusual type of nerve entrapment that is sometimes confused with or can develop at the same time as tennis elbow. What Happens Tennis elbow pain is a symptom of tendon injury. [myhealth.alberta.ca]

A preliminary physical examination to evaluate the extent of motion ability of the elbow, forearm and wrist would be carried out. The individual would also be asked to move his fingers in various ways to analyze the restricted mobility of the fingers. In many cases, physical examination is enough to diagnose the condition. However, certain others tests may need to be conducted to further confirm the diagnosis. X-rays and other imaging studies of the affected area may help to arrive at a definite diagnosis [6] [7].

Mild cases of tennis elbow often resolve on their own. Over the counter pain relieving medications along with physical therapy may also be beneficial. Physical therapy has strong basis in treatment of tennis elbow. The following methods of physical therapy include [8]:

• Proper techniques: Learning and mastering the art of proper techniques while playing tennis will help reduce the incidence of tennis elbow. Players should seek help from experts to learn the proper movements that would help exert minimal pressure on the injured tissue.
• Exercises: Exercises go a long way in strengthening the muscles of the forearm. A physiotherapist would teach individuals various types of exercises that would aid in easy stretching of the forearm muscles.
• Physical support: Physical support in the form of braces would also be provided to be worn on the forearm. This would help relieve the pressure and stress on the injured tissue [9].

When over the counter medications and physical therapy do not seem to work then surgery may be implicated in such cases. Surgical intervention to remove the damaged tissue is conducted. However, extensive physical therapy would be extremely necessary for recovery.

The prognosis of the condition is favorable with medications and individuals do not always require surgical intervention. However, those who have undergone surgery can fully utilize their elbow and forearm post surgery.

The major cause of tennis elbow is repetitive use of the extensor muscle of the forearm [2]. Such an activity causes muscles strain injury which in turn predisposes an individual to develop tennis elbow. The type of arm motion employed by tennis players, that of the backhand stroke, is known to be the most common cause of tennis elbow. However, the condition can also occur in other types of motions involved while using plumbing tools, driving screws and painting [3].

Tennis elbow is a common condition affecting about 5 in 1000 adults annually. Individuals between the age group of 35 to 55 years more commonly fall prey to the condition. Men and women are equally affected and it is a common occurrence in those with unfit forearm muscles.

Tennis elbow affects about 39.7% of tennis players. Of these, about 50 of them reported their symptoms to be debilitating and severe. The duration of playing tennis is also considered to be an important marker for development of tennis elbow. It has been reported that those players who play for more than 2 hours a day are at an increased risk of developing the condition [4].

Repeated use of the extensor muscles of the forearm causes tennis elbow. When these muscles are repeatedly used then small tear develops in the tendons. The tendons which attach the muscles of the forearm to the bone of the elbow undergo tear as a result of repeated peculiar kind of motion. As the condition progresses, irritation and pain develops at the site of tear.

The condition is a common occurrence amongst tennis players who frequently use the backhand stroke. Activities that involve repeated wrist movements also can lead to tennis elbow [5].

It is not always possible to prevent the development of tennis elbow. Individuals are advised to seek prompt treatment to prevent onset of irreversible damages. When individuals develop tennis elbow they should restrict any movement concerning the forearm and the wrist. Exercises are a great way of strengthening the muscles which can prevent injury to the forearm muscles [10].

In addition to tennis players, the condition also strikes carpenters, plumbers, painters and butchers. This is because such kind of people repeatedly make use of the extensor muscles of the forearm which predisposes them to develop tennis elbow. In majority of the cases, over the counter medications can help relieve the pain caused due to tennis elbow. However, when these do not work, surgery may be indicated [1].

Definition

Tennis elbow is characterized by development of pain in the lateral side of the upper arm. It is a common occurrence amongst tennis players. However, individuals who are in other occupation of painting and carpentry also fall prey to tennis elbow.

Cause

Repeated use of forearm muscles induces stress and causes tear in the tendons that join the muscles to the bone of the elbow. Tennis players develop the condition due to constant use of the backhand stroke while playing tennis.

Symptoms

Symptoms of tennis elbow include pain that originates on the lateral side of the upper arm and radiates down the wrist. Movements become difficult and individuals experience great deal of discomfort while performing activities such as stretching and pulling.

Diagnosis

In many cases, physical examination to study the motion ability of the wrist and forearm is enough for diagnosis. However, imaging studies such as X-rays and MRI can be done to confirm the diagnosis.

Treatment

Over the counter pain medications along with physical therapy helps in treating the condition. Braces in the form of physical support may also be advised to support the affected area. However, when conservative therapy does not work for more than 6 to 12 months, then surgery may be carried out to remove the damaged tissue.

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