The repetitive wrist movement causes degeneration in tendons that attach the forearm muscles to the arm bone. Symptoms and the intensity of pain may vary.
People suffering from tennis elbow often have tenderness in the elbow and the back of the forearm, which worsens with repeated use of the elbow especially during twisting movements. Common symptoms of tennis elbow include:. Tennis elbow most commonly affects people between the ages of 30 to People may often attribute the pain to growing older and hope that by ignoring it, the pain will go away. However, if left untreated, tennis elbow can progress into a debilitating injury that could eventually require surgery.
Another common misconception about tennis elbow is that taking anti-inflammatory medications or using topical creams can cure tennis elbow. Most cases of tennis elbow respond to rest, ice, rehab exercises, pain medicine, and counterforce braces.
This injury does take from 6 months to 12 months to heal. Patience helps. Surgery is considered as a last resort when all other nonsurgical treatments have failed. You may be referred for surgery if:. In as many as 9 out of 10 people who have tennis elbow, symptoms go away and the people can return to their normal activities whether they have had surgery or not.
The best way to prevent tennis elbow is to stretch and strengthen your arm muscles so that they are flexible and strong enough for your activities. If you feel that certain activities at your job are causing elbow pain or soreness, talk to your human resources department for information on other ways of doing your job. They can help with changes to equipment or other job assignments.
Consider taking lessons to learn the proper technique for sports, such as tennis and golf, that require grasping and twisting motions in the arm. Have a sports trainer or a person who is familiar with sports equipment check yours to make sure it suits your level of ability, body size, and body strength. In daily routines or hobbies, look for activities that use repeated arm movements that strain your fingers, wrist, or forearm, such as in gardening, cooking, or playing musical instruments.
Train yourself to use techniques that won't stress your elbow. For example, when you lift objects, lift with the palm of your hand facing upwards. If you have tennis elbow, follow these simple steps to reduce pain and start tendon healing. A rehab program such as this will prevent further injury by making your arm muscles stronger. Along with tendon rest, people often use medicine to treat tennis elbow.
Medicine can help with pain and relieve or reduce swelling. Nonsteroidal anti-inflammatory drugs NSAIDs , including aspirin such as Bayer , ibuprofen such as Advil , or naproxen such as Aleve , are the most commonly used medicines for treating tennis elbow.
NSAIDs are available with or without a prescription. NSAIDs come in pills and in a cream that you rub over the sore area. Acetaminophen such as Tylenol can also help with pain.
Be safe with medicines. Read and follow all instructions on the label. Your doctor may suggest corticosteroid injections shots if you are still in pain after at least 6 to 8 weeks of tendon rest and rehab. Corticosteroids are a class of powerful anti-inflammatory medicine. Even though inflammation isn't usually present in long-term chronic tennis elbow, corticosteroid shots may ease elbow pain for a short time. But in the long term, having the steroid shot may not help any more than not having it.
But they can reduce pain and give you enough relief to start rehab. Most cases of tennis elbow are treated without surgery. Less than 5 out of cases require surgery. Your doctor may suggest that you try a corticosteroid injection before you think about surgery. A steroid shot may help ease elbow pain for a short time.
But over the long term, having the steroid shot may not help any more than not having it. During surgery, a doctor will most likely cut release the tendon, remove damaged tissue from the tendon, or both. In some cases, tendon tears can be repaired. After surgery, rehab is needed to restore flexibility and strength in the forearm. Surgery for tennis elbow involves cutting releasing the tendon and removing damaged tissue from the tendon. In some cases, tendon tears are repairable reattached if the repair can be done without overtightening the tendon.
These procedures can be done both arthroscopically and through a larger incision open surgery or with a combination of the two techniques. There are different approaches to surgery for tennis elbow, such as where to enter the elbow and what type of reconstruction or repair on the tendon is done. Surgical technique is determined by the type, location, and severity of the injury and by the doctor's preference and experience.
There is no strong medical research that shows that one type of surgery is better than another or that surgery is better than other treatment.
The success of surgery depends in large part on the amount of time and effort you put into a rehab program. Other treatment for tennis elbow pain includes physical rehabilitation rehab , acupuncture, topical nitric oxide, shock wave therapy, and transcutaneous electrical nerve stimulation TENS. Physical rehab is combined with tendon rest to restore flexibility and build muscle strength. Rehab is needed after surgery too. A physical rehab program not only helps heal injured tendons and muscles but also helps prevent further injury.
Physical rehab combined with tendon rest is the main tennis elbow treatment. Corticosteroid shots are only considered if several weeks of rest and rehab have not reduced symptoms. Surgery may be considered after 6 to 12 months of nonsurgical treatment. If the type of work you do is causing your injury, an occupational therapist may help you change how you are working or the kind of work that you do. Blahd Jr. Author: Healthwise Staff. Medical Review: William H. This information does not replace the advice of a doctor.
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What causes tennis elbow? How is tennis elbow diagnosed? How is it treated? Rest your arm, and avoid any activity that makes the pain worse. As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day.
Always put a thin cloth between the ice and your skin. Keep using ice as long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you. Take over-the-counter pain relievers such as ibuprofen or naproxen NSAIDs or acetaminophen if you need them. Wear a counterforce brace when you need to grasp or twist something.
This is a strap around your forearm worn around your forearm just below the elbow. It may ease the pressure on the tendon and spread force throughout your arm. To avoid damaging your tendon again: Take lessons or ask a trainer or pro to check the way you are doing your activity.
If the way you use a tool is the problem, try switching hands or changing your grip. Make sure you are using the right equipment for your size and strength. Always take time to warm up before and stretch after you exercise. After the activity, apply ice to prevent pain and swelling. Health Tools Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health problems. Cause Overuse of the forearm muscles using a repeated twisting motion is the most common cause of tennis elbow. Tennis elbow injuries can result from: Overuse. Repeated movements that involve twisting of the elbow cause small tears in the tendon, weakening it. Overuse depends on how hard or how long you do something. Technique, or the way you do an activity. This includes holding equipment or a tool in a awkward position while you use it.
This can happen, for example, if you use a tool or sports equipment that is too heavy for you or that has a grip that is the wrong size for your hand. A single accident, such as a direct hit to the side of the elbow lateral epicondyle , or falling on an outstretched arm. Symptoms Tennis elbow symptoms usually begin gradually.
Tennis elbow pain: Usually occurs in the dominant arm your right arm if you are right-handed, or left arm if you are left-handed. Affects the outside of the elbow the side away from your body. Pain increases when that area is pressed or when you are grasping or twisting objects. May increase in the evening and make sleep difficult. The elbow might be stiff in the morning.
Over time may occur with mild activity, such as picking up a coffee cup, turning a jar lid or doorknob or key, or shaking hands. Simply starting your car could hurt. You may even have pain when you aren't using your elbow.
What Happens Tennis elbow pain is a symptom of tendon injury. Mild soreness in the elbow that comes and goes may improve in 6 to 8 weeks. Prolonged elbow pain and soreness may improve in 6 to 12 months. Severe elbow pain or tennis elbow that doesn't improve with 6 to 12 months of tendon rest and rehab may benefit from surgery. What Increases Your Risk Risk factors for tennis elbow include: Activities that involve repeated movements of the forearm, wrist, and fingers. This includes grasping and twisting arm movements done in jobs such as carpentry, plumbing, or working on an assembly line , daily activities such as lifting objects or gardening , and sports such as racquet sports, throwing sports, or swimming.
Improper techniques while doing certain movements, such as gripping a handle or twisting an object. Improper equipment for work, daily activities, and sports, such as using a hammer or a tennis racquet with a grip that is the wrong size for your hand. During the physical exam, your doctor may apply pressure to the affected area or ask you to move your elbow, wrist and fingers in various ways.
In many cases, your medical history and the physical exam provide enough information for your doctor to make a diagnosis of tennis elbow. But if your doctor suspects that something else may be causing your symptoms, he or she may suggest X-rays or other types of imaging tests. Our caring team of Mayo Clinic experts can help you with your tennis elbow-related health concerns Start Here.
Tennis elbow often gets better on its own. But if over-the-counter pain medications and other self-care measures aren't helping, your doctor may suggest physical therapy. Severe cases of tennis elbow may require surgery. If your symptoms are related to tennis, your doctor may suggest that experts evaluate your tennis technique or the movements involved with your job tasks to determine the best steps to reduce stress on your injured tissue.
A physical therapist can teach you exercises to gradually stretch and strengthen your muscles, especially the muscles of your forearm. Eccentric exercises, which involve lowering your wrist very slowly after raising it, are particularly helpful.
A forearm strap or brace may reduce stress on the injured tissue. You're likely to first bring your problem to the attention of your family doctor. He or she may refer you to a sports medicine specialist or an orthopedic surgeon. Tennis elbow care at Mayo Clinic. Mayo Clinic does not endorse companies or products.
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