A Family Doctor's Tale - TENNIS ELBOW

DOC I HAVE TENNIS ELBOW

Tennis Elbow (also known as epicondylitis) is the inflammation and swelling of the tendon sheaths (called the synovium) and the enclosed tendons at the origin of the flexor muscles at the medial epicondyle or extensor muscles at the lateral epicondyle of the elbow.

The lateral epicondyle of the elbow is more commonly affected.


The cause of Tennis Elbow is unknown.

Some possible causes are:
1.Injury or trauma to the tendon-minor tears in the tendon attachment of these muscles are always present

2.Repetitive usage of extensor or flexor muscles of the forearm

3.Arthritis of the elbow joints may predispose to Tennis Elbow

4.Systemic diseases such as multiple sclerosis ,amyloidosis, rheumatoid arthritis

The symptoms and signs of Tennis Elbow are:

Onset is usually gradual.
Symptoms:
1.Pain on movement of the tendon of the muscles of elbow

2.Swelling of part of the tendon affected at the elbow joint

3.Stiffness of the tendon of the elbow - inability to stretch

4.Pain often radiates into the forearm

Signs:
1.swelling and pain localized at the epicodyle of the elbow

2.Rotation and grasping such as using a screwdriver or opening a jar aggravates the pain

3.There may be local tenderness of the inflammed tendon.

4.Extension or flexion of the hand against resistance can cause pain at the affected epicondyle of the elbow

5. X-ray s are usually normal although a traction spur may be present.

The complications of Tennis Elbow are:
Fibrosis and rupture of the inflammed tendon of the muscles of the elbow may occur leading to loss of function of the elbow.

The Treatment of Tennis Elbow is:

Conservative treatment:
1.rest of the tendon

2.Cold or ice may help reduce inflammation

3.Splints over the hand, wrist and elbow may help to rest the tendons

4.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain

5.Muscle relaxant to relax muscles

6.injection of local anesthetic and long acting steroid into the affected area may help to reduce inflammation

7.Avoid overusage of the tendons and muscles of the elbow

Surgery :
Surgical reattachment of torn muscles of the elbow may be necessary if conservative treatment does not work.

The prognosis of Tennis Elbow is:
Prognosis is usually good although recurrence may occur after cortisone injection.

Surgery usually give excellent results.

The prevention of Tennis Elbow is:
1. Avoid any physical exercises such as tennis or golf which causes repetitative usages of the tendons and muscles of the elbow.

2.Avoid rotation or twisting movement of the muscles of the forearm which can cause minor tears of the tendons or muscles of the elbow.