Understanding Tennis Elbow: A Common But Manageable Condition

On a quiet Thursday afternoon, Jonathan, one of my regular patients, walked into my clinic with a rather sheepish smile. He was holding his right arm awkwardly, cradling it with his left hand. “Dr. Priya, I think I did something to my elbow,” he said, taking a seat.

Jonathan is a carpenter by trade, and his job involves repetitive arm movements. He explained that over the past few weeks, he’d been experiencing persistent pain on the outer side of his right elbow. “It’s gotten to a point where even lifting a cup of coffee feels like a challenge,” he admitted.

What Is Tennis Elbow?

I nodded as I examined his arm. Jonathan, it sounds like you’re dealing with something we call tennis elbow, or lateral epicondylitis,” I explained. “Despite the name, you don’t have to be a tennis player to develop it. It’s a condition that happens when the tendons in your elbow are overused, usually from repetitive motions.”

Research published in the Journal of Orthopaedic Surgery estimates that tennis elbow affects 1 to 3% of the population annually, particularly those between the ages of 35 and 55. It’s common in people who perform repetitive tasks, such as carpenters, plumbers, and even office workers who type for long hours.

What Causes Tennis Elbow?

I continued to explain to Jonathan the root cause of his discomfort. “The pain you’re feeling is due to inflammation of the tendons that attach to the lateral epicondyle — the bony bump on the outer side of your elbow. Repeated bending and twisting movements, like the ones you do at work, can overstrain these tendons.”

Common causes include:

• Repetitive use of hand tools, such as hammers or screwdrivers
• Carrying heavy loads
• Wringing wet clothes
• Playing racquet sports or golf

Interestingly, a study from the British Journal of Sports Medicine found that up to 50% of tennis players experience some degree of tennis elbow during their careers, but non-athletic activities can be just as likely to cause it.

What Are the Symptoms?

Jonathan nodded as I described the typical symptoms of tennis elbow:

• Pain and tenderness on the outer side of the elbow
• Weak grip strength
• Difficulty lifting or gripping objects
• Pain that worsens with wrist or hand movements

“The pain can interfere with sleep and even simple tasks like shaking hands or turning a doorknob,” I added.

How Is Tennis Elbow Diagnosed?

“The good news is, we can usually diagnose tennis elbow based on your symptoms and a physical examination,” I told Jonathan. I gently pressed on his lateral epicondyle, causing him to wince slightly.

“See? That tenderness confirms it,” I said. “We don’t usually need imaging tests unless we suspect a different condition.”

What Is the Treatment for Tennis Elbow?

Jonathan was relieved to hear that tennis elbow is a treatable condition. I outlined a comprehensive management plan for him.

Rest and Activity Modification

“First and foremost, you need to give your elbow some rest,” I advised. “Avoid activities that aggravate the pain, and try to modify your work habits.”

A 2020 review in The American Journal of Physical Medicine & Rehabilitation emphasized the importance of rest and ergonomic adjustments to prevent recurrence.

Pain Relief

You can take over-the-counter painkillers like ibuprofen or paracetamol to manage the pain,” I suggested. “Applying ice packs to the affected area can also help reduce inflammation.”

Exercises

Once the acute pain subsides, we’ll start you on some gentle exercises to strengthen your forearm muscles,” I explained.

I demonstrated a few exercises:

1. Dumbbell Exercise:
   • Sit in a chair with your arm resting on a table.
   • Hold a light dumbbell (about 0.5 kg) with your palm facing down.
   • Slowly raise and lower the weight 12 times. Repeat twice a day.
2. Towel-Wringing Exercise:
   • Roll up a towel and hold it with both hands.
   • Twist the towel as if wringing out water, first in one direction, then the other.
   • Hold for 10 seconds each way, gradually increasing to 60 seconds.

Bracing and Armbands

“Some people find relief using a forearm brace or armband,” I mentioned. “It helps reduce the strain on the tendons during daily activities.”

Research in The Journal of Hand Therapy has shown that wearing a brace can reduce pain and improve grip strength in patients with tennis elbow.

Preventing Tennis Elbow

Before Jonathan left, I gave him some tips to prevent future episodes:

• Warm up before activities
• Use proper technique when lifting or gripping
• Take regular breaks during repetitive tasks
• Use ergonomic tools to reduce strain

FAQs About Tennis Elbow