Tennis Elbow Treatment Specialist Q&A

Tennis elbow, also known as lateral epicondylitis, refers to a set of symptoms experienced with overuse of the elbow and its tendons. These tendons, often referred to as extensors, are strong tissue bands that attach the muscles of the forearm to the bones of the arm.

The origin (start) of the forearm extensors attaches to a bony prominence of the humerus (upper arm bone) called the lateral epicondyle, hence the name lateral epicondylitis. Specifically, the extensor carpi radialis brevis (ECRB) tendon is most commonly the source of inflammation and pain.

The first sign of tennis elbow is typically pain on the outer part of the elbow, where the palpable bony prominence, the lateral epicondyle, is located. Anecdotal, this pain is an aching and burning sensation that can radiate down the forearm to the wrist and hand. Pain will worsen with continued use of the damaged tissues, by contracting the muscles of the forearm of gripping objects.

Some patients experience worsened pain as well and find braces that restrict movement and promote compression to help alleviate their symptoms. You may also notice a weakening in your grip strength or stiffness in the elbow, especially if the extensor carpi radialis brevis (ECRB) tendon is to blame, as it functions to stabilize the wrist when the elbow is straightened.

The cause of tennis elbow is overuse of the muscles and tendons in the forearm, especially with repetitive elbow movements like that seen while playing tennis. Over time this repeated contraction and muscular strain cause the strength of the tendons to wear down and decline. Alongside inflammation, microtears at the origin of tendons may be seen, and are cause for pain. Though this condition is most commonly referred to as “tennis” elbow, many other sports and non-sport activities can cause it.

Many recent studies have concluded that those working in occupations involving repetitive elbow movements, such as carpentry, housekeeping, butchery, and many others can lead to the same problem. It is important to scratch and warm up effectively before completing a session of strenuous activity, so as to prevent damage to your muscles, tendons, and ligaments. On the contrary, tennis elbow may be entirely idiopathic, meaning there is seemingly no cause. Though this is not common, it is possible. As you age, the likelihood of developing tennis elbow increases, as do most musculoskeletal conditions. The prevalence of tennis elbow is equal among men as it is among women.

Tennis elbow is diagnosed through a comprehensive interview and physical exam by a healthcare provider. During an interview, your doctor will ask you various questions regarding your experience and symptoms.

Your pain will be evaluated by using the acronym PQRST, to most effectively determine important information. P: your doctor will ask what provokes the pain (making it worse), or what remedy techniques you’ve found palliative, or alleviating. Patients with tennis elbow find movement worsens the pain, while wrist stretches and alternating hot and cold compresses help reduce pain. Your doctor will ask you what your pain feels like, to gauge the quality of it. Often, pain associated with the tennis elbow is described as an aching sensation. R: your doctor will ask you in what region the pain is felt and if it radiates further. Tennis elbow pain is most felt at the exterior prominence of the elbow where the inflamed tendons originate, and it can radiate through the lower arm. This is where your doctor will ask you to rate the severity of your pain on a scale of one to ten. The answer to this question will vary amongst patients, and severity and pain tolerance is diverse. And finally, T: your doctor will ask you when your pain first began, and if it is present all of the time or if it comes and goes in waves.

Acute cases of tennis elbow will likely have symptoms that get lighter or stronger, depending on the activity level of the elbow in question. Through these questions, and a brief physical exam in which the doctor views and palpates the affected area, tennis elbow is diagnosed. Though medical imagery cannot indicate the presence of the condition, it can help to rule out other possible diagnoses. If you have tennis elbow or have questions, please reach out to our team at The Orthopedic Group through our website. We serve patients from Leesburg VA, Lansdowne VA, Stone Springs VA, Dulles, VA, Ashburn VA, Sterling VA, Aldie VA, South Riding VA, Herndon VA, Winchester VA, Reston VA, and Chantilly VA.