Sunday, July 26, 2009

Tennis elbow

What is tennis elbow?

Tennis elbow is known as lateral epicondylitis; it is caused by repetitive microtrauma to the extensor tendons of the forearm (due to over use) causing pain in the outer side of elbow.

What parts of the elbow are affected?

Pain starts on the outer side of the elbow (lateral epicondyle)

Who can develop tennis elbow?

Almost anyone can develop, mostly who are engaged in repetitive activities that include.

* hand grasping tennis, gardening, swimming, carpentry.
* Golfing, bricklaying, using scissors or shears.
* Squash, changing occupations, picking up a new sport and starting a new hobby.

What are the symptoms?

* Constant pain localized to the region of the lateral epicondyle which is made worse with active contraction of the wrist.
* spreading of pain may down the forearm up to middle and ring fingers.
* Inability to hold a coffee cup or hammer.
* sleep disturbance due to pain
* Band like thickening over affected elbow
* reduced grip strength.

What is the cause?

Overuse of the muscles and tendons of the forearm and elbow causes inflammation, wear and tear in the tendon. The tears try to heal, but constant strain and overuse keep re-injuring the tendon and thus forms scar tissue. Degeneration, bone spurs and calcifications.

What investigations are helpful?

* x-rays rule out other problems with the elbow joint
* Calcium deposits on the lateral epicondyle may be seen.
* Ultrasound-shows problems with collagen degeneration.
* MRI-when the diagnosis is not clear.

What can be done to make pain go away?

The goal is to help the tendon heal in elbow
* Tablets-ibuprofen, voveran reduces the inflammation and pain of sudden onset. Elbow strap-relieves the pressure on the tendon
* Exercises are used to gradually stretch and strengthen the forearm muscles.
* Iontophoresis-apply ice and electrical inflammatory medication with temporary benefits (can last for a period of weeks to several months)
* Ultrasound therapy, hot and cold fermentations, shock wave therapy
* Surgery is done for unbearable pain despite above measures. It can be done using a general anesthetic or a regional anesthetic.
* Tendon debridement
* Tendon release
You do not have to have bad technique or be a couch potato to develop tennis elbow, but eliminating as many causes as possible may be your ticket to cure tennis elbow.

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