Tennis Elbow
Treatment
Dr Chiam Tut Fu
MBBS (Singapore)
MSS (Sports Medicine) (USA)
MMed (OM) (Singapore)
GDOM (Singapore)
DWD (Singapore)
What is a Tennis Elbow?
Tennis elbow, or lateral epicondylitis, is a condition causing pain on the outside of the elbow. It occurs when the tendons in the elbow are overused, usually due to the repetitive wrist and arm motions. Although often associated with tennis players, anyone can develop tennis elbow from various activities that strain the elbow joint.
Symptoms of Tennis Elbow
Tennis elbow primarily causes pain and tenderness on the outside of the elbow. The symptoms often develop gradually and may worsen over time. Common symptoms include:
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Pain and Stiffness
Pain on the outside of the elbow can extend down the forearm and into the wrist. It is often felt during activities that involve lifting, bending the arm, gripping small objects, or twisting the forearm.
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Weakened Grip
People who have tennis elbow often experience weakened grip strength. This can make everyday tasks challenging, such as shaking hands, turning a doorknob, or holding objects like a coffee cup.
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Worsening Pain with Activity
Pain associated with tennis elbow tends to worsen with activities involving repetitious wrist and elbow use. Actions such as lifting, gripping, or twisting motions can increase the pain. The pain can intensify with continuous or strenuous activity, making it challenging to complete tasks that require sustained arm use.
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Burning Sensation
Some people may experience a burning sensation on the outer part of the elbow. This sensation is often particularly noticeable after intense activity or prolonged use of the forearm muscles.
What are the Causes and Risk Factors of Tennis Elbow?
Several factors can contribute to the development of this condition. Here are the main causes and risk factors:
- Repetitive Motions: Engaging in repetitive wrist and arm motions, such as painting, typing, or using hand tools, can lead to tennis elbow. The repeated strain on the elbow joint results in small tears in the tendons over time.
- Improper Technique: Using incorrect techniques during sports or physical activities can place additional strain on the tendons.
- Sports: While tennis is commonly associated with tennis elbow, sports like baseball, fencing, and weightlifting can also contribute to its development. Any sport that involves repetitive arm and wrist movements can increase the risk.
- Occupational Factors: Jobs that require frequent and repetitive arm movements, such as carpentry, plumbing, or working on an assembly line, can increase the risk of developing tennis elbow. Continuous strain on the elbow from these activities can result in tendon injuries.
- Age: Tennis elbow is more common in adults between the ages of 30 and 50. Middle-aged people are more likely to have this condition because tendons become less flexible and more prone to injury as they age.
- Genetic Predisposition: Some people may have a genetic predisposition to developing tendon-related conditions, including tennis elbow. Genetic factors can influence tendon strength and elasticity, making some prone to tendon injuries.
Diagnosis of Tennis Elbow
Accurate diagnosis is important to differentiate tennis elbow from other conditions that cause elbow pain. The following methods are typically used:
Medical History
A doctor will begin by taking a detailed medical history, including questions about the onset of symptoms, activities that worsen the pain, and any previous injuries or conditions affecting the elbow. Understanding the patient’s activity level and specific movements that trigger pain helps form a diagnosis.
Physical Examination
During a physical examination, the doctor will check for pain and tenderness on the outside of the elbow. They may also ask the patient to perform certain movements to assess pain levels and muscle strength. Common tests include:
- Resisted Wrist Extension Test: The patient extends their wrist against resistance. Pain over the lateral epicondyle during this test suggests tennis elbow.
- Chair Raise Test: The patient lifts a chair with their palm facing downwards. Pain during this action can indicate tennis elbow.
- Palpation of the Lateral Epicondyle: The doctor presses on the lateral epicondyle to check for tenderness and pain response.
Imaging Tests
Imaging tests provide detailed visuals of the elbow’s internal structures, helping to confirm a diagnosis of tennis elbow or rule out other conditions. These tests include:
- X-rays: Used to exclude other conditions such as arthritis or fractures in the elbow. Although they do not show soft tissue damage, they can help identify bony abnormalities.
- MRI (Magnetic Resonance Imaging): Can provide detailed images of the tendons and muscles around the elbow. It helps in assessing the extent of tendon damage and inflammation.
- Ultrasound: Ultrasound imaging is used to visualise the tendons in real-time. It helps in detecting tendon tears and inflammation.
Electromyography (EMG)
EMG may be used to rule out nerve compression conditions, which can mimic the symptoms of tennis elbow. This test measures the electrical activity of muscles and helps identify nerve-related issues.
Minimally Invasive Treatments We Use To Treat
Tennis Elbow
An injection that alleviates pain and inflammation associated with musculoskeletal conditions such as tennis elbow.
Targeted pain relief and reduced inflammation.
Little to no recovery time. Patients may resume their normal activities promptly.
PRP therapy involves injecting a concentration of the patient's platelets into the affected tendon to promote healing. It is effective in treating chronic tendon injuries with slow recovery.
Promotes healing and reduces inflammation.
Little to no downtime. Patients can resume normal activities shortly after the procedure.
This treatment involves injecting hyaluronic acid into the joint to improve lubrication and reduce pain. It helps restore the viscoelasticity of the synovial fluid.
Improves joint lubrication and reduces pain.
Results usually last for 2-3 months. In some cases, the relief can last for 6-12 months.
Radio-frequency therapy uses controlled heat to relieve pain and promote tissue healing in the affected tendon. It is effective in reducing inflammation and providing quick symptom relief.
Reduces inflammation and promotes tissue healing.
Can quickly relieve symptoms, usually within 1-3 days.
LLLT uses low-level lasers to reduce pain and inflammation and promote healing in the tendon tissues. This treatment is used for various musculoskeletal conditions.
Painless, quick, effective, and no downtime.
Patients can return to their normal activities immediately after an LLLT session.
Dr Chiam Tut Fu
(詹达夫医生)
MBBS (Singapore)
MSS (Sports Medicine) (USA)
MMed (OM) (Singapore)
GDOM (Singapore)
DWD (Singapore)
Dr Chiam is a MOH accredited Specialist in Sports Medicine and has practised medicine for over 30 years.
Dr Chiam Tut Fu obtained his MBBS from National University of Singapore in 1990. He went on to obtain his Masters in Sports Science (Sports Medicine) from the United States Sports Academy, graduating as the year’s outstanding student, and Masters of Medicine (Occupational Medicine) from the National University of Singapore.
Key Interests:
- Non-surgical treatment of sports injuries
- Non-surgical treatment of degenerative conditions
- Nutraceuticals for healthy ageing and exercise performance
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Singapore Paincare Center
Paragon Medical Centre, #18-03
290 Orchard Road, Singapore 238859
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Frequently Asked Questions
How long does it take to recover from tennis elbow?
Recovery time varies depending on the severity of the condition and the treatment used. Non-surgical treatments can take several weeks to a few months, while surgical recovery may take several months.
Is tennis elbow treatment painful?
Some treatments, like physical therapy and corticosteroid injections, may cause temporary discomfort. Minimally invasive treatments and surgery generally involve some pain during recovery, but pain management strategies are available.
When should I see a doctor for tennis elbow?
If you experience persistent elbow pain that doesn’t improve with rest and home remedies or interferes with daily activities, you should see a doctor for evaluation and treatment.
Can tennis elbow recur after treatment?
Yes, tennis elbow can recur if preventive measures are not taken. It’s important to continue strengthening and stretching exercises, use proper techniques, and make lifestyle adjustments to avoid re-injury.