Tennis and Golfer’s Elbow

Tennis elbow (epicondylitis) is a common musculoskeletal condition that causes pain around the outside of the elbow.

Tennis elbow occurs after repetitive activity and strenuous overuse of the extensor muscles (the gripping muscles) and tendons of the forearm, close to the elbow joint.

Symptoms

The first signs of tennis elbow include:

  • pain when lifting or bending your arm
  • pain when gripping small objects such as a pen
  • pain on the outside of your upper forearm, just beneath the bend of your elbow
  • pain when twisting your forearm to turn door handles or opening jars
  • difficulty in extending your arm
Causes

Tennis elbow is not a condition exclusive to people who play tennis or other racket sports; people whose jobs include a level of manual work actually have a greater likely hood of developing the condition. Tennis elbow can also be caused by other activities such as playing the violin or decorating.

Tennis elbow is most often caused by the overuse of the extensor muscles in your forearm. These muscles are attached to your elbow and are used to grip objects and to straighten your wrist. When these muscles become strained, tiny tears (micro-tears) and inflammation develop near the bony lump (the lateral epicondyle) on the outside of your elbow (see diagram).

When pain occurs on the inner side of the elbow, (inflammation and tears to the medial epicondyle), the condition is known as golfer’s elbow.

Treatment

If your symptoms do not improve after resting your arm for a few days, you will need to visit your GP who can refer you to Mr Bhatia for further examination and tests. If your pain is significant and thought to be caused by nerve damage, Mr Bhatia may require you to undergo a ultrasound scan or MRI scan for further investigation.

If left to rest, tennis elbow can eventually get better without treatment, however there are a number of treatments that can help to speed up your recovery.

One of the simplest treatments is simply to apply a cold compress, such as a bag of ice or frozen peas wrapped in a towel, against your elbow for a few minutes several times a day. Taking pain killers, such as paracetamol, and anti inflammatories such as ibuprofen, will help to reduce the pain and the inflammation. If the problem still persists, physiotherapy may be recommended to help improve the movement in your arm.

In the most severe cases, surgery may be required to remove the damaged part of the tendon.

Surgery

There are a number of different surgical procedures that Mr Bhatia may utilise to treat tennis elbow. These include:

  • Cutting and releasing the tendon.
  • Repairing tendon tears by reattachment.
  • Removing any inflamed tissue from the tendon.

Surgery may be performed under general or regional anaesthetic, and can be undertaken through arthroscopy, open surgery or a combination of the two techniques.

Tennis elbow surgery will usually require an overnight stay in hospital.

Recovery

Although recovery times can vary from person to person, generally most recovery times for tennis elbow surgery take between 3-6 months.

Recovery time can be shortened through rehabilitation, and by spending time with physiotherapists available at Mr Bhatia’s Bristol clinics.