What are the main symptoms of tennis elbow. How is tennis elbow caused. What are the most effective treatments for tennis elbow. Who is at risk for developing tennis elbow. How can tennis elbow be prevented. What is the outlook for patients with tennis elbow. When should you see a doctor about elbow pain.

Understanding Tennis Elbow: More Than Just a Sports Injury

Tennis elbow, medically known as lateral epicondylitis, is a condition that extends far beyond the tennis court. Despite its name, this painful ailment affects a wide range of individuals, from athletes to office workers. But what exactly is tennis elbow, and why does it occur?

Tennis elbow is characterized by inflammation or microtearing of the tendons that connect the forearm muscles to the outer part of the elbow. These tendons and muscles become damaged due to repetitive motions, leading to pain and tenderness on the lateral side of the elbow.

What causes tennis elbow?

The primary cause of tennis elbow is overuse of the forearm muscles, particularly the extensor carpi radialis brevis (ECRB). This muscle plays a crucial role in stabilizing the wrist when the elbow is straight, such as during a tennis backhand stroke. Repetitive use can lead to microscopic tears in the tendon where it attaches to the lateral epicondyle, resulting in inflammation and pain.

• Repetitive motions
• Overuse of forearm muscles
• Poor technique in sports or work activities
• Weak forearm muscles
• Age-related degeneration

Recognizing the Symptoms: When to Suspect Tennis Elbow

The onset of tennis elbow is typically gradual, with symptoms worsening over weeks or months. Recognizing these symptoms early can lead to faster treatment and recovery. But what should you look out for?

What are the main symptoms of tennis elbow?

The primary symptoms of tennis elbow include:

• Pain or burning sensation on the outer part of the elbow
• Weakened grip strength
• Pain that worsens with forearm activity
• Discomfort when extending the wrist against resistance
• Occasional pain at night

It’s important to note that these symptoms often intensify with activities that involve gripping or manipulating objects, such as holding a racquet, turning a wrench, or even shaking hands.

Who’s at Risk? Identifying Vulnerable Groups

While the name might suggest otherwise, tennis players aren’t the only ones susceptible to this condition. In fact, a wide range of occupations and activities can put individuals at risk for developing tennis elbow.

Who is most likely to develop tennis elbow?

Several factors can increase the likelihood of developing tennis elbow:

1. Age: Most cases occur in individuals between 30 and 50 years old
2. Occupation: Painters, plumbers, carpenters, auto workers, cooks, and butchers are at higher risk
3. Sports activities: Tennis, racquetball, and other racquet sports players
4. Repetitive arm motions: Any activity requiring frequent extension of the wrist and hand

Interestingly, tennis elbow can also occur without any recognized repetitive injury, a condition known as idiopathic lateral epicondylitis.

Diagnosis: How Tennis Elbow is Identified

Accurate diagnosis of tennis elbow is crucial for effective treatment. But how do medical professionals determine if someone is suffering from this condition?

How is tennis elbow diagnosed?

The diagnosis of tennis elbow typically involves a combination of approaches:

• Medical history: Your doctor will inquire about the development of symptoms, occupational risks, and sports participation
• Physical examination: Various tests will be performed to pinpoint the source of pain
• Resistance tests: You may be asked to straighten your wrist and fingers against resistance
• Imaging tests: In some cases, X-rays or MRI scans may be ordered to rule out other conditions

It’s essential to provide your doctor with a comprehensive history, including any previous elbow injuries or conditions like rheumatoid arthritis or nerve diseases.

Treatment Options: From Conservative Care to Surgical Intervention

Once diagnosed, the treatment of tennis elbow often involves a multidisciplinary approach. But what are the most effective treatments available?

What are the primary treatment options for tennis elbow?

Treatment for tennis elbow typically progresses from conservative measures to more invasive options if necessary:

1. Rest and activity modification
2. Ice or heat therapy
3. Anti-inflammatory medications
4. Physical therapy and exercises
5. Bracing or splinting
6. Corticosteroid injections
7. Platelet-rich plasma (PRP) injections
8. Extracorporeal shock wave therapy
9. Surgery (in severe or persistent cases)

The choice of treatment depends on the severity of the condition and the individual’s response to conservative measures. Most cases of tennis elbow respond well to non-surgical treatments, with surgery reserved for cases that don’t improve after 6-12 months of conservative care.

Prevention Strategies: Keeping Tennis Elbow at Bay

While treatment options are available, prevention remains the best approach to dealing with tennis elbow. But how can one reduce the risk of developing this painful condition?

How can tennis elbow be prevented?

Several strategies can help prevent the onset or recurrence of tennis elbow:

• Proper technique: Ensure correct form in sports and work activities
• Equipment check: Use appropriate gear and tools for your activities
• Strength training: Focus on exercises that target the forearm muscles
• Stretching: Regular stretching of the forearm muscles can improve flexibility
• Ergonomic adjustments: Modify your work environment to reduce strain on your arms
• Rest and recovery: Allow adequate time for your muscles and tendons to heal between activities

By incorporating these preventive measures into your daily routine, you can significantly reduce your risk of developing tennis elbow.

Living with Tennis Elbow: Managing Symptoms and Improving Quality of Life

For those diagnosed with tennis elbow, the journey to recovery can be challenging. However, with proper management and care, it’s possible to alleviate symptoms and improve overall quality of life.

What lifestyle changes can help manage tennis elbow?

Several lifestyle modifications can aid in managing tennis elbow symptoms:

1. Ergonomic adjustments: Modify your workspace to reduce strain on your arms
2. Activity modification: Avoid or limit activities that exacerbate symptoms
3. Use of assistive devices: Consider using braces or supports during activities
4. Regular exercise: Engage in approved strengthening and stretching exercises
5. Stress management: Chronic pain can be stressful, so incorporate stress-reduction techniques

Remember, recovery from tennis elbow is often a gradual process. Patience and consistency in following your treatment plan are key to successful management.

When to Seek Medical Attention: Recognizing Red Flags

While many cases of tennis elbow can be managed at home, there are instances when professional medical attention is necessary. But how do you know when it’s time to see a doctor?

When should you consult a doctor about elbow pain?

Consider seeking medical attention if you experience:

• Severe pain that interferes with daily activities or sleep
• Persistent pain that doesn’t improve with rest and home treatments
• Inability to carry objects or use your arm
• Elbow pain accompanied by fever, redness, or swelling
• Any deformity of the elbow joint

Early intervention can prevent the condition from worsening and potentially speed up the recovery process.

The Role of Physical Therapy in Tennis Elbow Recovery

Physical therapy plays a crucial role in the treatment and rehabilitation of tennis elbow. But what exactly does physical therapy entail for this condition?

How does physical therapy help in treating tennis elbow?

Physical therapy for tennis elbow typically involves:

1. Manual therapy: Hands-on techniques to improve joint mobility and reduce pain
2. Strengthening exercises: Targeted exercises to improve forearm muscle strength
3. Stretching routines: Exercises to improve flexibility and reduce tension
4. Ultrasound therapy: To promote healing and reduce inflammation
5. Education: Teaching proper techniques and ergonomics to prevent recurrence

A tailored physical therapy program can significantly accelerate recovery and help prevent future episodes of tennis elbow.

Emerging Treatments: New Horizons in Tennis Elbow Care

As medical science advances, new treatments for tennis elbow continue to emerge. What are some of the promising new approaches to managing this condition?

What are some innovative treatments for tennis elbow?

Several cutting-edge treatments are showing promise in the management of tennis elbow:

• Platelet-rich plasma (PRP) therapy: Using the patient’s own blood components to promote healing
• Stem cell therapy: Harnessing the body’s regenerative capabilities to repair damaged tissue
• Percutaneous tenotomy: A minimally invasive procedure to remove damaged tissue
• Shockwave therapy: Using acoustic waves to stimulate healing in the affected area
• Nitric oxide patches: Applying patches to increase blood flow and promote tissue repair

While these treatments show promise, it’s important to note that more research is needed to fully establish their long-term efficacy and safety.

The Impact of Tennis Elbow on Daily Life and Work

Tennis elbow can significantly impact an individual’s daily activities and work performance. But how exactly does this condition affect one’s quality of life?

How does tennis elbow affect daily activities and work?

The impact of tennis elbow on daily life can be substantial:

1. Difficulty with simple tasks: Opening jars, turning doorknobs, or shaking hands can become painful
2. Work limitations: Certain occupations may become challenging, potentially leading to reduced productivity or time off work
3. Sports restrictions: Athletes may need to limit or modify their training and competition schedules
4. Sleep disturbances: Pain may interfere with sleep, leading to fatigue and reduced overall well-being
5. Emotional impact: Chronic pain and activity limitations can lead to frustration or depression

Understanding these impacts is crucial for both patients and healthcare providers in developing comprehensive management strategies.

The Connection Between Posture and Tennis Elbow

While often overlooked, posture plays a significant role in the development and management of tennis elbow. But how exactly are posture and tennis elbow related?

How does posture contribute to tennis elbow?

Poor posture can contribute to tennis elbow in several ways:

• Increased strain: Poor posture can place additional stress on the forearm muscles and tendons
• Muscle imbalances: Postural issues can lead to imbalances in muscle strength and flexibility
• Altered biomechanics: Improper posture can change how forces are distributed through the arm during activities
• Reduced blood flow: Poor posture can restrict blood flow to the affected area, potentially slowing healing
• Nerve compression: Certain postural habits can lead to nerve compression, exacerbating symptoms

Addressing postural issues can be an important component of both prevention and treatment strategies for tennis elbow.

Nutrition and Tennis Elbow: The Role of Diet in Recovery

While often overlooked, nutrition plays a crucial role in the healing process of tennis elbow. But how exactly can diet influence recovery from this condition?

How can diet support recovery from tennis elbow?

A balanced diet can support recovery from tennis elbow in several ways:

1. Anti-inflammatory foods: Consuming foods rich in omega-3 fatty acids and antioxidants can help reduce inflammation
2. Protein intake: Adequate protein is essential for tissue repair and muscle strength
3. Collagen-boosting nutrients: Vitamin C and amino acids support collagen production, crucial for tendon health
4. Hydration: Proper hydration supports overall tissue health and function
5. Micronutrients: Vitamins and minerals like vitamin D, calcium, and magnesium play roles in musculoskeletal health

While diet alone cannot cure tennis elbow, a nutritious eating plan can support the body’s natural healing processes and complement other treatment strategies.

The Psychological Aspect of Tennis Elbow Recovery

The impact of tennis elbow extends beyond physical symptoms, often affecting an individual’s mental and emotional well-being. But how significant is the psychological component in recovery from tennis elbow?

How does the mental aspect influence tennis elbow recovery?

The psychological aspect of tennis elbow recovery is multifaceted:

• Pain perception: Mental state can influence how pain is experienced and tolerated
• Adherence to treatment: Positive mindset can improve commitment to rehabilitation programs
• Stress management: Chronic pain can increase stress, which in turn can exacerbate symptoms
• Fear of re-injury: Anxiety about recurrence can hinder return to normal activities
• Depression: Prolonged pain and activity limitations can lead to mood disorders

Addressing the psychological aspects of tennis elbow through techniques like mindfulness, cognitive-behavioral therapy, or counseling can be an important component of a comprehensive treatment plan.

Long-term Outlook: What to Expect After Tennis Elbow

For those diagnosed with tennis elbow, understanding the long-term prognosis is crucial. But what can patients expect in terms of recovery and potential recurrence?

What is the long-term outlook for patients with tennis elbow?

The long-term outlook for tennis elbow is generally positive:

1. Recovery time: Most cases improve within 6-12 months with proper treatment
2. Recurrence risk: About 80-90% of patients have good to excellent long-term outcomes
3. Residual symptoms: Some patients may experience mild, intermittent symptoms even after treatment
4. Activity modification: Long-term management may involve ongoing adjustments to activities
5. Prevention focus: Emphasis on prevention strategies to avoid recurrence

Tennis Elbow (Lateral Epicondylitis) – OrthoInfo

Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. However, several other sports and activities besides sports can also put you at risk.

Tennis elbow is inflammation or, in some cases, microtearing of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists and, in some cases, surgeons work together to provide the most effective care.

Your elbow joint is a joint made up of three bones: the upper arm bone (humerus) and the two bones in the forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles, where several muscles of the forearm begin their course. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle.

The ECRB muscle and tendon is usually involved in tennis elbow.

Reproduced and modified from The Body Almanac. © American Academy of Orthopaedic Surgeons, 2003.

Muscles, ligaments, and tendons hold the elbow joint together.

Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of your forearm that are responsible for the extension of your wrist and fingers. Your forearm muscles extend your wrist and fingers. Your forearm tendons — often called extensors — attach the muscles to bone.  The tendon usually involved in tennis elbow is called the extensor carpi radialis brevis (ECRB).

Overuse

Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The ECRB muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example. When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.

The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.

Activities

Athletes are not the only people who get tennis elbow. Many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle or repetitive extension of the wrist and hand.

Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.

Playing tennis is a possible cause of tennis elbow, but other activities can also put you at risk.

Thinkstock © 2015.

Age

Most people who get tennis elbow are between the ages of 30 and 50, although anyone can get tennis elbow if they have the risk factors. In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.

Unknown

Lateral epicondylitis can occur without any recognized repetitive injury. This occurrence is called idiopathic, or of an unknown cause.

The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.

Common signs and symptoms of tennis elbow include:

• Pain or burning on the outer part of your elbow
• Weak grip strength
• Sometimes, pain at night

The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is most often affected; however, both arms can be affected.

Location of pain in lateral epicondylitis.

Reproduced and modified from Griffen L (ed): Essentials of Musculoskeletal Care, Third Edition. © American Academy of Orthopaedic Surgeons, 2005.

Your doctor will consider many factors in making a diagnosis. These include how your symptoms developed, any occupational risk factors, and recreational sports participation.

Your doctor will talk to you about what activities cause symptoms and where on your arm the symptoms occur. Be sure to tell your doctor if you have ever injured your elbow. If you have a history of rheumatoid arthritis or nerve disease, tell your doctor.

During the examination, your doctor will use a variety of tests to pinpoint the diagnosis. For example, your doctor may ask you to try to straighten your wrist and fingers against resistance with your arm fully straight to see if this causes pain. If the tests are positive, it tells your doctor that those muscles may not be healthy.

During the exam, your doctor will apply gentle pressure to the lateral epicondyle, checking for pain and tenderness.

Tests

Your doctor may recommend additional tests to rule out other causes of your problem.

• X-rays. X-rays provide clear images of dense structures, such as bone. They may be taken to rule out arthritis of the elbow.
• Magnetic resonance imaging (MRI) scan.  MRI scans provides images of the body’s soft tissues, including muscles and tendons. An MRI scan may be ordered to determine the extent of damage in the tendon or to rule out other injuries. If your doctor thinks your symptoms might be related to a neck problem, they may order an MRI scan of the neck to see if you have a herniated disk or arthritic changes in your neck. Both of these conditions can produce arm pain.
• Electromyography (EMG). Your doctor may order an EMG to rule out nerve compression. Many nerves travel around the elbow, and the symptoms of nerve compression are similar to those of tennis elbow.

Nonsurgical Treatment

Approximately 80 to 95% of patients have success with nonsurgical treatment.

Rest. The first step toward recovery is to give your arm proper rest. This means that you will have to stop or decrease participation in sports, heavy work activities, and other activities that cause painful symptoms for several weeks.

Medications. Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may be taken to help reduce pain and swelling

Physical therapy. Specific exercises are helpful for strengthening the muscles of the forearm. Your therapist may also perform ultrasound, ice massage, or muscle-stimulating techniques to improve muscle healing.

Wrist stretching exercise with elbow extended.

Brace. Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce symptoms by resting the muscles and tendons.

Counterforce brace.

Steroid injections. Steroids, such as cortisone, are very effective anti-inflammatory medicines. Your doctor may decide to inject the painful area around your lateral epicondyle with a steroid to relieve your symptoms.

Platelet-rich plasma. Platelet-rich plasma (PRP) is a biological treatment designed to improve the biologic environment of the tissue. This involves obtaining a small sample of blood from the arm and centrifuging it (spinning it) to obtain platelets from the solution.  Platelets are known for their high concentration of growth factors, which can be injected into the affected area. While some studies about the effectiveness of PRP have been inconclusive, others have shown promising results.

An injection of PRP is used to treat tennis elbow.

Courtesy of Allan K. Mishra, MD, Menlo Park, CA.

Extracorporeal shock wave therapy. Shock wave therapy sends sound waves to the elbow. These sound waves create microtrauma that promotes the body’s natural healing processes. Shock wave therapy is considered experimental by many doctors, but some sources show it can be effective.

Equipment check. If you participate in a racquet sport, your doctor may encourage you to have your equipment checked for proper fit. Stiffer racquets and looser-strung racquets often can reduce the stress on the forearm, which means that the forearm muscles do not have to work as hard. If you use an oversized racquet, changing to a smaller head may help prevent symptoms from recurring.

Surgical Treatment

If your symptoms do not respond after 6 to 12 months of nonsurgical treatments, your doctor may recommend surgery.

Most surgical procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to bone.

The right surgical approach for you will depend on a range of factors. These include the scope of your injury, your general health, and your personal needs. Talk with your doctor about the options. Discuss the results your doctor has had, and any risks associated with each procedure.

Open surgery. The most common approach to tennis elbow repair is open surgery. This involves making an incision over the elbow.

Open surgery is usually performed as an outpatient surgery. It rarely requires an overnight stay at the hospital.

Arthroscopic surgery. Tennis elbow can also be repaired using miniature instruments and small incisions. Like open surgery, this is a same-day or outpatient procedure.

Surgical risks. As with any surgery, there are risks with tennis elbow surgery. The most common things to consider include:

• Infection
• Nerve and blood vessel damage
• Possible prolonged rehabilitation
• Loss of strength
• Loss of flexibility
• The need for further surgery

Rehabilitation. Following surgery, your arm may be immobilized temporarily with a splint. About 1 week later, the sutures and splint are removed.

After the splint is removed, exercises are started to stretch the elbow and restore flexibility. Light, gradual strengthening exercises are started about 2 months after surgery.

Your doctor will tell you when you can return to athletic activity. This is usually 4 to 6 months after surgery. Tennis elbow surgery is considered successful in 80 to 90% of patients. However, it is not uncommon to see a loss of strength.

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How To Treat Elbow Tendonitis and Tennis Elbow Pain

Elbow tendonitis, also called lateral epicondylitis, is an inflammation of the connective tissue that fastens the muscles in the forearm to the elbow. The tendons attach to the outside edge of the upper arm bone (i.e., the humerus), where it meets the elbow. This type of elbow pain is also called tennis elbow. Learning how to treat elbow tendonitis is a good thing to know before the tendonitis pain occurs.

Tendonitis is caused by overuse of the forearm muscles, but playing a lot of tennis with its repetitive forearm motion is only one way of irritating these tendons. Plumbers, carpenters, and painters commonly develop tennis elbow as they engage in repetitive motions, too. Knowing how to treat elbow tendonitis is useful for different kinds of people who develop this elbow pain.

Other athletes also develop elbow tendonitis — such as golfers and baseball players. The typical age for developing tendonitis is 30 to 50 years, but this varies widely. Every year, 1% to 3% of the population gets elbow tendonitis. Knowing how to treat elbow tendonitis is important for everyone as anyone can develop this painful condition.

Elbow Tendonitis Symptoms

The main symptom of elbow tendonitis is pain (sometimes a burning pain) and tenderness on the outside of the elbow. Stiffness and pain in the elbow in the morning or at night are also common and are worse when trying to use the hand or arm.  
Because the muscles, tendons, and nerves travel through the arm, the pain, while usually worse over the elbow, can travel to the upper arm, lower arm, and to the wrist and hand. Some people who do not know recognize elbow tendonitis, find they have problems shaking hands, turning doorknobs, and holding objects. They may think the problem is in the hand or wrist when it is elbow tendonitis. However, one can also experience elbow pain when lifting and tendonitis is the most common cause of such discomfort.

How to Treat Elbow Tendonitis at Home

If people learn how to treat lateral epicondylitis, they can often successfully treat their symptoms at home. The initial steps should be done when pain and tenderness develop over the outer elbow area:

1. Rest the arm to decrease further injury.
2. Apply ice wrapped in a towel or very cold water in a paper cup to the injured area for 20 minutes. Do this 3 or 4 times a day for the first few days to minimize inflammation and further injury.
3. Elbow pain and inflammation can often be treated with medications such as ibuprofen, acetaminophen, or naproxen.

Doing these things when an injury that seems like elbow tendonitis becomes apparent can improve the speed and likelihood of a full recovery. Treating elbow tendonitis at home can save time recovering.

Other options for those wanting to know how to treat elbow tendonitis at home include a tennis elbow brace. Applying a tight compression brace over the muscles and tendons just below the elbow helps to keep these structures from irritating the tendonitis by pushing the forces when using the arm down the arm and away from the center of irritation. A brace also helps to let the muscles and tendons rest.

There are a variety of braces and compression bands for people seeking treatment for elbow tendonitis. Finding the correct style and fit is somewhat a matter of personal choice, but an orthopedic specialist can also be of tremendous assistance in choosing the best device.

Naturally, knowing if an elbow or arm injury is, in fact, tendonitis is important for treating elbow pain. 

When in doubt, an orthopedic doctor can do a physical examination, take a good history of a patient’s activities, and order x-rays.

If a question remains about the diagnosis, a CT scan, MRI, or nerve conduction study can be performed.

Elbow Tendonitis Exercises

Another element for those who want to know how to treat elbow tendonitis is exercise or physical therapy. Here are some helpful exercises for elbow tendonitis:

• Wrist Extension Stretch – With the elbows loose, straighten the arm and bend the wrist back as if signaling “stop.” It is okay to use the opposite hand to help straighten the hand gently. Hold the position for about 15 seconds and repeat five times.

• Wrist Flexion Stretch – Doing the same as the wrist extension, except the wrist is bent down (opposite of “stop”). Use the opposite hand to help. Hold the position for 15 seconds and repeat five times.

• Wrist Extension Strengthening – This exercise is performed in stages, and after a few days of doing it with no pain, add a lightweight such as one pound.

• Wrist Flexion Strengthening – This exercise is also performed in stages with a lightweight added only after a few days with no pain.

• Stress Ball Squeeze – Squeeze the ball using all of the fingers as hard as possible without causing any pain. Do this daily with ten repetitions. A rolled-up sock or towel can also be used.

• Finger Stretch – Place a rubber band over the four fingers on the hand about midway down the finger. Spread your fingers against the resistance of the rubber band. Repeat ten times each day.

• Wrist Turn – Bend the elbow at a right angle with the palm facing up. Turn the hand over slowly until the palm is facing down. Hold this position for 5 seconds and try to repeat ten repetitions.

• Towel Twist – Holding a loosely rolled towel lengthwise, twist the towel by moving the hands in opposite directions. Do ten repetitions in one direction and ten in the opposite direction.

While these are examples of some of the many exercises that can be done at home if one knows how to treat elbow tendonitis, they should be done carefully and gradually, especially at first. Significant pain is a sign that the exercises are either not good for the injury or are being done with too much force. Gradually increasing the strength used with each exercise is the key.

When To See a Doctor About Elbow Tendonitis

While it is very valuable to know how to treat elbow tendonitis as most cases can successfully be treated at home, improper treatment or no treatment usually results in tendonitis lasting six months to 2 years before resolving. During this time, pain and disability occur daily. If a patient employs the various treatment strategies for 6 to 12 months without significant improvement, surgery may be recommended.
While rarely necessary, when surgery is needed, it is usually done arthroscopically or with an open incision made over the outer elbow. The abnormal and inflamed tissue is removed, and after a brief recovery period, most surgical patients do extremely well. Patients still need to understand how to treat elbow tendonitis because part of the healing process will involve the same exercises as patients who have not had surgery. Ultimately, only about 10% or fewer patients will require some sort of surgical treatment.

It is necessary to see an orthopedic specialist if you know how to treat elbow tendonitis and have been treating it with no improvement after a few weeks or months. While it is often gradual, some improvement should be obvious within the first few weeks. Also, when you have questions about diagnosis, treatment options, or exercises for your elbow, finding the best orthopedic specialists is easy.

Other Causes of Elbow Pain

Of course, there can always be other reasons for discomfort in your elbow. Outer and inner elbow pain of different types help to diagnose these various ailments. 

Some of these causes can include: 

• Dislocation
• Valgus Extension Overload (VEO)
• Ulnar Collateral Ligament Injury
• Elbow Sprain
• Ulnar Neuritis
• Golfer’s elbow
• Trapped nerves
• Osteoarthritis
• Rheumatoid arthritis
• Osteochondritis dissecans
• Fractured or Broken arm
• Bursitis
• and more

Before self-diagnosing, contact one of the specialists at The Orthopedic Institute of New Jersey. There are locations throughout New Jersey. For a consultation about elbow tendonitis, contact an OINJ doctor near you.

This article was reviewed and approved by an orthopedic surgeon as we place a high premium on accuracy for our patients and potential patients.

Elbow Tendinitis: Causes and Treatment

Contents

• 1 Elbow Tendinitis Causes and Treatments: A Detailed Overview
  • 1.1 Elbow Tendinitis: What is it?
  • 1.2 Causes of Elbow Tendinitis
  • 1.3 Symptoms of Elbow Tendonitis
  • 1.4 Diagnosis of Elbow Tendonitis
  • 1.5 How to Prevent Elbow Tendinitis

  90 005 1.6 Classification of tendonitis of the elbow

  • 1.7 Treatment of tendonitis of the elbow
  • 1.8 Surgical treatment of tendonitis of the elbow
    • 1.8.1 Arthroscopy
    • 1.8.2 Open extirpation
    • 1.8.3 A autotransplantation
  • 1.9 Consequences of tendinitis of the elbow joint
  • 1.10 Timing of tendinitis treatment elbow joint
  • 1.11 Elbow tendinitis prevention
  • 1.12 Related videos:
  • 1.13 Q&A:
    • • 1.13.0.1 What is elbow tendonitis?
      • 1.13.0.2 What causes tendonitis of the elbow?
      • 1.13. 0.3 What are the symptoms of tendonitis of the elbow?
      • 1.13.0.4 Which doctor treats tendonitis of the elbow?
      • 1.13.0.5 How is elbow tendonitis treated?
      • 1.13.0.6 What are the possible complications of tendinitis of the elbow?

Explore the main causes of elbow tendinitis and find out what treatments can help you get rid of this condition. Find out how to correctly identify the symptoms of tendinitis and what procedures will help restore the elbow joint.

It is rare to find a person who does not experience pain in the elbow joint. One of the most common conditions is tendinitis, an inflammation of the tendons that run through the joint. It can occur in athletes and people who perform the same type of hand-related activities on a daily basis, such as computer work.

However, tendonitis itself is only a symptom, not a disease. When it occurs in the elbow, a person may experience pain, limitation of movement, and even loss of strength in the hand and forearm. What causes tendinitis to develop? How can it be treated and prevented in the future?

In this article, we will look at the main causes and treatments for tendinitis of the elbow joint. You will learn how to correctly diagnose the disease, what treatment is most effective, and what measures can be taken to prevent the occurrence of tendinitis in the future.

Elbow tendinitis: what is it?

Elbow tendinitis, or epicondylitis, is inflammation of the tendon on the outside or inside of the elbow joint. This disease often occurs in people who are busy working with repetitive hand movements and loads on the elbow.

Additional signs of tendinitis of the elbow joint may be swelling at the site of inflammation and the appearance of redness.

• Often occurs when working with a power tool;
• Manifested by pain in the elbow, which may increase with movement;
• May require long term treatment;
• In the treatment, restriction of the load on the elbow and a course of drugs from the NSAID group are indicated;

Causes of elbow tendonitis

Elbow tendonitis is an inflammatory disease of the tendons of the elbow part of the forearm. It often occurs in people who play sports or perform the same type of monotonous movements, such as painting or working on a computer.

The main cause of tendinitis of the elbow joint is tendon and muscle overload. Constant loads on the elbow joint cause microtraumas, which, with constant repetitions, can lead to tissue destruction.

Also, tendonitis of the elbow can be caused by trauma, viral infections, autoimmune diseases, metabolic disorders, as well as improper exercise technique and insufficient warm-up before playing sports.

1. Tendon and muscle overload – the main cause of elbow tendonitis
2. Microtrauma caused by constant stress on the elbow joint can lead to tissue destruction.
3. Injuries, viral infections and autoimmune diseases can also cause tendonitis of the elbow.
4. Incorrect exercise technique and insufficient warm-up can damage tissues and cause elbow tendonitis.

Symptoms of tendonitis of the elbow joint

1. Pain. One of the main symptoms of elbow tendinitis is pain, which may be sharp or dull, but is always present. It increases with the movements of the hand and can manifest itself both in the elbow joint itself and in the entire arm.

2. Edema. The appearance of edema at the site of injury is also a symptom of tendonitis. Edema indicates the presence of inflammation, which appears as a result of overload of ligaments and ligaments.

3. Difficulties with movement. Elbow tendonitis can also lead to impaired arm movement. This is because the soreness makes itself felt when flexing or extending the elbow joint and leads to difficulty in performing normal movements.

4. Redness of the skin. In some cases, redness may appear on the surface of the skin near the elbow, indicating the presence of an inflammatory process in the surrounding tissues.

5. Consequences. If left untreated, tendonitis of the elbow can become chronic and cause serious consequences, including arthritis that interferes with daily tasks.

Diagnosis of tendinitis of the elbow

The main symptom of tendinitis of the elbow is pain in the elbow. Pain can be caused by both movement and rest. In addition, the patient may experience a sensation of numbness or tingling in the arm associated with a disruption in normal blood flow.

Magnetic resonance imaging is one of the most accurate methods for diagnosing tendinitis of the elbow joint. This method allows the most detailed study of the structure of soft tissues, the presence of inflamed areas and changes in the structure of the joints.

• Other methods of diagnosing tendinitis of the elbow may include:
• Computed tomography, which provides more accurate data on the structure of the skeleton;
• Ultrasound diagnostics, which is used to study soft tissues and helps to detect inflammation, deformities and injuries;
• Blood tests that can be used to diagnose inflammation in the body.

For accurate diagnosis of tendinitis of the elbow joint, it is necessary to conduct a comprehensive diagnosis, including all of the above methods.

How to Prevent Elbow Tendinitis

Elbow Tendinitis can be prevented by keeping your physical activity in check.

Stretch your elbow muscles before training. When muscles are bent for a long time, they become less flexible and more prone to injury.

Avoid monotonous movements. If you do work that involves repetitive movements, try to vary your work to reduce stress on the elbow joint.

Stop if pain occurs. If you feel pain in your elbow, stop and take a break until the pain subsides.

Strengthen your muscles. Various exercises for the elbow muscles can help strengthen them, which can reduce the risk of tendinitis.

Do not load the elbow joint with the wrong weight. If you lift weights, make sure you do it correctly so that you don’t lose your balance at the elbow.

Avoid excessive loading. Do not put too much stress on the elbow joint to avoid injury.

Classification of tendonitis of the elbow

Depending on the site of occurrence:
Elbow tendonitis can occur on the inside or outside of the joint. In the first case, this is called medial, and in the second – lateral tendinitis.

Depending on severity:
Tendonitis can be mild, moderate or severe. Mild tendonitis usually resolves quickly on its own or with simple treatment, while severe tendonitis can lead to tendon destruction or even bone fracture.

Depending on the cause:
For the treatment of tendinitis of the elbow joint, doctors divide it into two main forms – traumatic tendinitis and degenerative tendinitis. The first occurs due to an injury to the joint, and the second is due to the gradual destruction of tissues due to prolonged inflammation.

Depending on the nature of the changes in the tissues:
It happens that tendinitis of the elbow joint goes through various stages, each of which undergoes certain changes. Thus, two main forms of tendinitis of the elbow joint can be distinguished: superficial tendinitis, which affects only the outer layers of tissues, and deep tendinitis, which affects the deeper layers of soft tissues.

Elbow tendonitis treatment

Elbow tendinitis treatment should be comprehensive and aimed at eliminating the causes of the disease, as well as reducing pain and restoring the functioning of the joint.

Anti-inflammatory and pain medications are prescribed to reduce pain. Some patients may require steroid injections into the area of ​​inflammation.

Physical therapy can be an effective treatment for tendonitis of the elbow. Techniques such as laser therapy, ultrasound, and magnetotherapy can help speed up the recovery process.

In severe cases, surgery may be required. Surgery may be necessary if conservative treatment fails to restore full joint function. Surgery may also be needed if elbow tendinitis is caused by problems with the structure of the joint or damage to the tendons.

Elbow tendinitis surgery

Arthroscopy

Arthroscopy is a surgical procedure that uses an arthroscope to allow treatment without surgical access. With tendinitis of the elbow joint, arthroscopy allows you to remove damaged tissue, reduce the inflammatory reaction and inhibit pain. This method is minimally invasive, gives a quick recovery and reduces the risk of complications.

Open extirpation

Open extirpation is a surgical treatment in which the damaged tendon is removed. In the process of treatment, manipulations are carried out to remove the damaged tendon. This method allows you to solve the problem associated with inflammatory processes penetrating into soft tissues, which will restore the full functioning of the elbow joint.

Autograft

Autograft is a technique in which a damaged tendon is replaced with a healthy one’s own tendon. The method is effective and allows you to restore the full work of the elbow joint. However, there is a small risk of complications associated with injury to more healthy tissues.

Sequelae of tendinitis of the elbow

Tendinitis of the elbow can lead to serious consequences if left unattended and treated. First of all, untreated tendinitis can lead to the development of chronic pain syndrome.

If elbow tendonitis is not treated on time, it can progress and lead to a number of complications. Baker’s cyst, impaired mobility of the arm, tendon rupture, and restriction of movement in the elbow joint are just some of them.

Finally, after treating tendonitis of the elbow, it is important to continue to work on its recovery. And also adhere to preventive measures to avoid repeated injuries and tension of muscles and tendons in the future.

Timing of treatment for tendonitis of the elbow

The duration of treatment for tendonitis of the elbow depends on the degree of injury and the individual characteristics of the patient.

In mild cases of tendonitis of the elbow, where only the small tendons are affected, treatment may take from a few days to two weeks.

Moderate cases of tendonitis of the elbow require three to six weeks of treatment. Complex therapy is often prescribed, including massage, muscle stretching exercises and the use of anti-inflammatory and pain medications.

Severe tendinitis of the elbow can last up to two to three months and requires an individual approach to treatment. Comprehensive treatment is often used, including massage, physiotherapy and medications. In some cases, surgery may be required.

Elbow Tendinitis Prevention

Elbow Tendinitis can be prevented with certain precautions and simple exercises.

• Avoid repetitive movements: Doing the same movement regularly can stress the elbow joint. Try to do a variety of exercises, rest and take breaks.
• Increase the intensity of exercise gradually: Starting with little exercise and gradually increasing it will help prevent tendonitis of the elbow.
• Do the exercises correctly: Do the exercises with the right technique to avoid overloading the elbow joint.
• Wear the right equipment: Wear good quality and proper equipment for sports or exercise to reduce the risk of elbow injury.
• Stretch your muscles: Stretch your arms and elbow muscles regularly to maintain flexibility and reduce the risk of elbow injury.

Proper prevention of elbow tendinitis can help prevent serious damage to the elbow and promote long-term joint health.

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Q&A:

What is elbow tendinitis?

Elbow tendinitis is an inflammation of the tendons that connect the muscles of the forearm to the elbow joint.

What causes tendinitis of the elbow joint?

Loads on arms and forearms, monotonous work at the computer, excessive training with weight lifting, injury possible.

What are the symptoms of tendinitis of the elbow?

It is manifested by pain in the elbow and forearm, a feeling of tension in the muscles, the elbow joint may be swollen and reddened.

Which doctor treats tendinitis of the elbow joint?

Treatment by an orthopedic traumatologist.

How is elbow tendonitis treated?

It includes prescription of anti-inflammatory drugs, physiotherapy, stretching exercises for muscles and tendons, as well as rest and reduction of stress on the forearm and elbow joint until complete recovery.

What are the possible complications after tendinitis of the elbow joint?

Relapses of the disease, development of chronic tendinitis, and even dysfunction of the elbow joint are possible.

Tendinitis: symptoms, causes, treatment

Tendinitis is a disease that manifests itself as an inflammatory process in the tendons. Pathology can occur in acute or chronic forms. In the second case, degenerative processes develop in the affected tendon. In most cases, the focus of inflammation is localized in the tissues adjacent to the bone. The symptoms of tendinitis are nonspecific: the patient suffers from pain when moving the limbs and a local increase in temperature. Perhaps the formation of mild edema and a zone of moderate hyperemia. Treatment of pathology in the initial stages involves the use of conservative methods. A running inflammatory process may require surgical intervention.

General

Tendinitis develops in patients of all ages. The risk group includes professional athletes and people engaged in monotonous physical labor. The focus of inflammation is formed due to excessive loads to which human tendons are subjected. Tissue microtraumas cause pain and an increase in local temperature.

Most often, the pathology affects the tendons located near the elbow, knee and hip joints. Less commonly, inflammation develops in the ankle and wrist joints. Age-related changes in the articular tissues lead to weakening of the ligaments – the likelihood of inflammation increases. Patients over 60 years of age may suffer from calcium deposits leading to a calcific form of the disease.

Reasons for the development of pathology

Symptoms of tendonitis, identified by an orthopedist during examination of a patient, may indicate the causes of inflammation in the tendon. Often tissue microtraumas are the result of a high level of human motor activity. The pathology is common among professional tennis players, golfers, javelin throwers and skiers. The monotonous movements characteristic of gardeners, carpenters or painters often cause inflammation of the tendons.

A quarter of clinically diagnosed cases of tendonitis develop under the influence of other factors: rheumatic pathologies or thyroid diseases. Inflammation of the tendons can be the result of gonorrhea, intoxication of the body or anomalies of the bone skeleton (different lengths of limbs, etc.).

Pathogenesis

Tendons are formed in the form of dense inelastic strands, consisting of bundles of collagen fibers. Thanks to them, muscle tissue is connected to the bones. Tendons transmit movement from the muscles to the skeleton and keep the joints stable. Intense and monotonous movements interfere with the process of natural restoration of collagen fibers – the first signs of tendinitis appear.

The structures of the tendon swell, individual strands of collagen begin to split. While maintaining a high load in the tissues, foci of fatty degeneration, necrosis and deposits of calcium salts are formed. Hardened calcifications lead to re-traumatization of the previously damaged area. The inflammatory process gradually spreads to the entire tendon.

Types of pathology

Tendonitis can affect tendons of any size – inflammatory processes develop in the tissues of the finger, hand, foot, elbow or knee. The classification of pathology used by orthopedists takes into account the localization of the focus of pathology. Doctors distinguish the following forms of the disease:

• lateral,
• medial,
• patellar tendon inflammation,
• inflammation of the tendon of the shoulder joint.

The lateral type of pathology develops in the tendons adjacent to the mice of the wrist (short and long extensors, brachioradialis, etc.). The patient is faced with pain spreading along the outer surface of the elbow joint. Over time, professional and amateur athletes develop hand weakness. A person begins to experience difficulties in performing elementary actions: twisting clothes, raising a cup with a drink, shaking hands.

The medial form of the disease affects the tendons adjacent to the flexor muscles of the forearm, elbow, and palm. Pathology is diagnosed 7–10 times less often than lateral tendinitis and develops in individuals who regularly perform rotational hand movements. The risk group includes golfers, seamstresses, professional recorders, gymnasts, tennis players and baseball players. The main symptom of the disease is acute pain localized on the inside of the elbow joint.

Inflammation of the patellar ligament tendon is diagnosed in individuals who frequently perform jumps. The cause of microtrauma is short-term intense loads on the quadriceps muscle. At the initial stages of the development of the pathology, the pain syndrome occurs after the patient completes physical activity. Later, pain appears during exercise or at rest.

Inflammation of the tendons of the shoulder joint affects the tissues adjacent to the muscles of the rotator cuff of the shoulder. Pain occurs with any action that requires the mobility of the arm. Acute attacks can develop at night. An increase in the size of the focus of inflammation leads to the formation of pronounced edema.

Symptoms

Symptoms of the disease appear gradually. In the early stages, the patient is faced with pain at the time of maximum physical exertion. The rest of the time, the injured tendon does not cause discomfort to the child or adult. Over time, the pain syndrome becomes more intense: discomfort occurs with minimal physical activity. If left untreated, the patient may be unable to perform daily activities: washing dishes, putting on clothes, fastening buttons, tying shoelaces.

The skin next to the focus of inflammation turns red, edema is formed. Local temperatures may rise. Palpation of the tendon increases pain. With sudden movements of the injured limb, the patient may hear a crunch or crack.

Diagnostics

Diagnosis of tendinitis is performed by an orthopedist. The doctor examines the patient and collects data for anamnesis. Confirmation of the primary diagnosis is performed by radiography, ultrasound and magnetic resonance imaging of the injured tendon.

X-ray allows you to identify foci of calcification that have formed in the collagen fibers. Visualization of the tendons during ultrasound demonstrates thickening of the tissues and a decrease in their echogenicity. MRI is used to determine the localization of the focus of inflammation and its size.

Treatment

The tactics of treating tendinitis is determined by the orthopedist, taking into account the data obtained during the diagnostic procedures. With severe pain syndrome, the patient is shown short-term immobilization of the limb. Medical therapy includes anti-inflammatory drugs. Tissue swelling is eliminated by phonophoresis and electrophoresis.

Relief of the pain syndrome will allow the patient to start therapeutic exercises. If acute pain persists, the child or adult receives glucocorticosteroid drugs in the form of injections. The ineffectiveness of conservative therapy becomes an indication for surgical intervention.

During the operation, surgeons can perform a complete or partial cutting off of the tendons from the muscles for the purpose of subsequent lengthening. The period of postoperative rehabilitation can last several months.

Prognosis and prevention

Timely initiation of treatment of inflammatory processes in the tendons allows doctors to form a favorable prognosis for most patients. With the advanced course of the pathology, systematic relapses and severe injuries of the limbs are likely. Surgical treatment allows achieving complete restoration of limb mobility in 85–90% of cases.

Prevention of tendinitis is based on the exclusion of excessive loads on the tendons. Athletes-amateurs and professionals should conduct a full warm-up before starting training or competition.

Diagnosis and treatment of tendinitis in Moscow

JSC “Medicina” (clinic of Academician Roitberg) has all the necessary equipment for the diagnosis and treatment of inflammatory processes in tendon tissues. Patients are admitted in a modern diagnostic complex, built with the latest advances in medicine.

Questions and answers

Which doctor treats tendinitis?

Pathology is treated by an orthopedist. With a complicated course of the disease, the patient may need to consult other doctors – a surgeon or a physiotherapist.

Is it possible to conservatively treat inflammation of the tendons?

Surgical intervention is an extreme measure used by doctors in case of low effectiveness of drug therapy.