Lateral Epicondylitis, commonly known as Tennis Elbow
Tennis elbow, also referred to as lateral epicondylitis, is a common cause of elbow pain in athletes. Tennis elbow is considered a cumulative trauma injury that occurs over time from repeated use of the muscles of the arm and forearm. The pain of tennis elbow is thought to be related to small tears and damage to the tendons that attach muscles of the forearm to the lateral epicondyle of the elbow. In most cases of chronic elbow pain, it is believed to be due to tendinopathy rather than tendinitis. This syndrome has been documented as one of the most prevalent disorders of the arm. Today, lateral epicondylitis can be seen across the working population, with repetitive arm type occupations.
Lateral epicondylitis is typically seen in individuals ranging from ages 40 to 50 and is seen equally among males and females. Annual incidence is 1 to 3 percent of the population per year. Lateral epicondylitis occurs 7 to 10 times more often than medial epicondylitis or “golfer’s elbow”. Populations at increased risk of injuries are workers in highly repetitive hand task industries, which include computer workers and construction workers. Half of tennis players will at some point have elbow pain and 75 to 80 percent of these players’ elbow pain will be related to the lateral epicondyle.
RSI (or “Repetitive Strain Injury”) is an umbrella term referring to various different conditions caused by repetitive tasks, forceful exertions, vibrations, or sustained/awkward positions.
Commonly, RSI is used to describe upper extremity injuries (e.g. to the fingers, hands and arms), but any body part can be affected (e.g. the trunk, back and legs
RSI diagnosis is today being less commonly used in diagnosis, as it has been deemed to be too general, not specific and not descriptive of location and injury type/severity.
Symptoms can vary and involve the swelling and inflammation of the muscles or tendons of an accepted medical condition, or present with no obvious symptoms, apart from pain so no formal diagnosis is possible (Also referred to as non-specific pain syndrome).
Tennis Elbow Symptoms
Pain on the outside of the elbow, usually during or after intense use, is the first sign of tennis elbow. In some cases, lifting or grasping objects may be difficult. In some patients, pain radiates down the arm.
- Elbow pain that gradually worsens
- Pain radiating from the outside of the elbow to the forearm and back of the hand when grasping or twisting
- Weak grasp
- Symptom onset generally occurs 24-72 hours after repeated wrist extension activity.
- Delayed symptoms are probably due to microscopic tears in the tendon.
- The patient complains of pain over the lateral elbow that worsens with activity and improves with rest. The patient will also often describe aggravating conditions such as a backhand stroke in tennis or the overuse of a screwdriver.
Early symptoms of RSI can include any or all of the following:
- Physical signs such as swelling or redness.
- These can affect the wrists, arms, shoulders, neck or legs during work.
These symptoms improve overnight or when the problem activity is deceased.
Note that these may last weeks or months, but is generally reversible. Prompt action is required however as RSI can quickly progress to more chronic stages.
Chronic RSI can be much more serious and harder to treat. These symptoms are similar to early symptoms but are more severe, the sufferer may be unable to carry out even light tasks at home or work and pain generally occurs earlier in the working day. They can also linger into the night causing lack of sleep, and may have a long lasting impact on your life.
This chronic stage may last for months or years. Sometimes it is irreversible and the person never gets back full use of the affected part of their body.
This stage of RSI is hard to treat and emphasises the importance of catching the condition early and doing something about it.
Research has outlined successful of treatment of lateral epicondylitis and RSI with conservative or non-operative techniques. Successful outcomes resulting from conservative treatment have been documented at rates of 89 to 90 percent. There are many treatment options for RSI and tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists such as Chiropractors and Physio, and, in some cases, surgeons work together to provide the most effective care.
A treatment and rehabilitation program is carefully designed by our practitioners at Spinal and Sports Care to meet the needs of the individual patient, depending on the type and severity of the injury. Active involvement of the patient and family is vital to the success of the program.
The goal of treatment and rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life–physically, emotionally, and socially.
In order to help reach these goals, Spinal and Sports Care treatment and rehabilitation programs may include the following:
- Physical Therapy and Chiropractic therapy.
- Exercise programs to stretch and strengthen the area.
- Conditioning exercises to help prevent further injury.
- Heat or cold applications.
- Use of braces or splints to immobilise the area.
- Pain management techniques.
- Patient and family education, especially regarding proper ergonomics for the workplace (ergonomics is the science of obtaining a correct match between the human body, work-related tasks, and work tools).