Tennis Elbow – Causes, Symptoms and Treatment
Tennis elbow is a painful condition caused by overuse of the tendons at the outer elbow. It is common among athletes and people performing repetitive arm movements.
Wissenswertes über "Tennis Elbow"
Tennis elbow is a painful condition caused by overuse of the tendons at the outer elbow. It is common among athletes and people performing repetitive arm movements.
What Is Tennis Elbow?
Tennis elbow, medically known as lateral epicondylitis or epicondylitis humeri radialis, is a painful condition affecting the outer side of the elbow. It involves irritation or inflammation of the tendon attachments of the forearm extensor muscles at the lateral epicondyle of the humerus – a bony prominence on the outer part of the upper arm bone. Despite its name, tennis elbow frequently occurs in people who have never played tennis.
Causes
The condition is caused by repetitive overuse of the forearm muscles, particularly through repetitive wrist and forearm movements. Common triggering activities include:
- Playing tennis (especially backhand strokes with poor technique)
- Manual work such as screwing, hammering, or sawing
- Office work involving intensive mouse and keyboard use
- Gardening or work with vibrating tools
Chronic overloading leads to small tears in the tendon tissue (microtraumas), resulting in a disrupted healing response and degenerative changes in the tendon.
Symptoms
The hallmark symptom of tennis elbow is pain on the outer side of the elbow, which can radiate into the forearm or hand. Other common complaints include:
- Pain when gripping, rotating the forearm, or lifting objects
- Tenderness directly at the lateral epicondyle
- Reduced grip strength
- Morning stiffness around the elbow
- Pain that worsens with activity and improves with rest
Diagnosis
The diagnosis is usually made clinically, based on the medical history and a physical examination. Typical clinical tests include:
- Thomson test: Pain when extending the wrist against resistance
- Chair test: Pain when lifting a chair with an extended arm
- Middle finger extension test: Pain when extending the middle finger against resistance
Imaging methods such as ultrasound or MRI (magnetic resonance imaging) are used in unclear cases or when planning treatment, and can reveal tendon changes, tears, or signs of inflammation.
Treatment
Conservative Therapy
In most cases, tennis elbow heals with conservative treatment. The following measures are recommended:
- Rest and load reduction: Avoiding the activities that trigger the condition
- Physiotherapy: Stretching and strengthening exercises, eccentric training of the forearm muscles
- Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac as gel or tablet
- Icing: Local application of cold for pain relief
- Epicondylitis brace (counterforce brace): To reduce pressure on the tendon attachments
- Shockwave therapy: Particularly effective for chronic cases
Injection Therapy
For severe pain, corticosteroid injections can provide short-term relief; however, repeated use is associated with an increased risk of relapse. Newer approaches such as platelet-rich plasma (PRP) injections show promising results in studies for chronic cases.
Surgical Treatment
Surgery is only considered in rare cases – when conservative treatment has not been successful after 6–12 months. The procedure involves removing degeneratively altered tendon tissue and reconstructing the tendon attachments.
Prognosis and Outlook
Tennis elbow generally has a good prognosis. With consistent treatment and avoidance of overloading, most cases heal completely within a few months to a year. Adjusting movement patterns and work techniques is important to prevent recurrence.
References
- Shiri R, Viikari-Juntura E: Lateral and medial epicondylitis: role of occupational factors. Best Practice & Research Clinical Rheumatology. 2011;25(1):43–57.
- Bisset L, Vicenzino B: Physiotherapy management of lateral epicondylalgia. Journal of Physiotherapy. 2015;61(4):174–181.
- Karanasios S et al.: Exercise interventions in lateral epicondylitis: a systematic review with meta-analysis. Journal of Hand Surgery European Volume. 2021;46(3):262–281.
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Verwandte Suchbegriffe: Tennis Elbow + Tennis-Elbow + Lateral Epicondylitis