Tennis elbow, or lateral epicondylitis, 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.
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.
Despite its name, athletes aren’t the only people who develop tennis elbow. People whose jobs feature the types of motions that can lead to tennis elbow include plumbers, painters, carpenters and butchers.
The pain of tennis elbow occurs primarily where the tendons of your forearm muscles attach to a bony bump on the outside of your elbow. Pain can also spread into your forearm and wrist.
The pain associated with tennis elbow usually has a gradual onset, but it may also come on suddenly.The pain associated with tennis elbow may radiate from the outside of your elbow into your forearm and wrist. Pain can be highly variable too, ranging from very mild to severe and debilitating.
A degenerative (“wear and tear”) process and subsequent pain and tenderness felt at the outside of the elbow. Pain and weakness may make it difficult to:
• Shake hands or grip an object
• Turn a doorknob
• Hold a coffee cup
• Raise your hand or straighten your wrist
Tennis elbow occurs when there is a problem with the tendon (called the extensor carpi radialis brevis muscle tendon) that attaches to the outside part of the elbow bone called the lateral epicondyle, thus giving tennis elbow the medical name ‘lateral epicondylitis’.This tendon is the attachment site of the muscle that functions to cock the wrist back (called wrist extension).
It’s important to note that tennis elbow is not simply a tendon “inflammation.” Rather, as a result of repetitive use, experts believe that incompletely healed microscopic tears develop within the tendon. This leads to a degenerative (“wear and tear”) process and subsequent pain and tenderness felt at the outside of the elbow.
Risk factors –
Factors that may increase your risk of tennis elbow include:
While tennis elbow affects people of all ages, it’s most common in adults between the ages of 30 and 50.
People who have jobs that involve repetitive motions of the wrist and arm are more likely to develop tennis elbow. Examples include plumbers, painters, carpenters, butchers and cooks.
• Certain sports.
Participating in racket sports increases your risk of tennis elbow, especially if you employ poor stroke technique.
To diagnose your tennis elbow, your doctor will do a thorough exam. They will want you to flex your arm, wrist, and elbow to see where it hurts. You may also need imaging tests, such as an X-ray or MRI (magnetic resonance imaging) to diagnose tennis elbow or rule out other problems.
Other tests, such as nerve conduction study and electromyography (EMG), are sometimes conducted to rule out nerve compression.
Blood tests may be utilized to help diagnose inflammatory conditions like rheumatoid arthritis.
Treatment of tennis elbow entails simple, non-surgical steps, and the good news is that with sufficient time, most individuals respond well.
▪︎ Non-Surgical Therapies
For most people, one or more of the following treatments are effective for treating tennis elbow:
• Rest and Activity Modification:
Stopping or significantly limiting activities that trigger and/or aggravate the condition (oftentimes for several weeks) is a key first step to healing.
Ice packs placed over the elbow can help reduce inflammation and relieve pain
Under the guidance of your healthcare provider, taking a nonsteroidal anti-inflammatory drug (NSAID), can ease inflammation and pain.
Wearing a tennis elbow brace (a band worn over the back of your forearm muscle just below your elbow) can ease the stress on the tendon and muscle.
• Physical therapy:
A physical therapist will use various exercises to strengthen the muscles of your forearm and promote healing. These may include arm exercises, ice massage, and muscle-stimulating techniques.
• Ultrasound therapy:
In ultrasound therapy, an ultrasound probe is placed over the most painful area on your arm. The probe emits high-frequency sound waves into the tissues for a set period of time. This type of treatment can help reduce inflammation and speed up recovery.
• Steroid Injection:
In certain cases, your healthcare provider may opt to inject cortisone (a strong anti-inflammatory medication) into the area near your lateral epicondyle.
It is usually best to begin treatments in a stepwise fashion, advancing to the next treatment only if one fails to alleviate your symptoms. It is also important to remember that most patients take a few months from the onset of symptoms to resolution of symptoms—it is rarely an overnight cure.
A small percentage of patients diagnosed with tennis elbow will ultimately require surgical treatment. Generally speaking, patients may consider surgery if more conservative treatments are not effective after a period of six to 12 months.
Ayurvedic Perspective –
According to Ayurveda, snayugata vata can be correlated with the condition of tennis elbow. Sushruta has advised Agnikarma for disorders of snayu (ligaments and tendons), asthi (bone), siddhi (joints) etc.
This condition is majorly caused due to the vitiation of Pitta dosha in the starting stage then leading to the aggravation of Vata dosha as well. The vitiated doshas results in difficulty of the movement of elbow.
Ayurvedic approach to the treatment of Tennis Elbow condition includes administration of anti-inflammatory Ayurvedic natural herbal medicines, application of medicated oils/powders to the area with –
• Mild Abhyanga with specific oils
• Churnapindaswedam or patrapotalaswedam
• Dhanyamladhara or sweating treatment (Swedana)
• herbal bandages
• Pichu treatment
– is also recommended depending upon the severity of the condition.
The treatments are aimed at improving the blood circulation and reducing the inflammation and strain to the affected tendon rather than painkilling.
There are a number of ways to help prevent tennis elbow, including:
• making sure you’re using the right equipment and proper technique for each sport or task
• performing exercises that maintain the strength and flexibility of the forearm
• icing your elbow following intense physical activity
• resting your elbow if it’s painful to bend or straighten your arm
If you take these steps and avoid putting strain on the tendons of your elbow, you can lower your chances of getting tennis elbow or prevent it from coming back.
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