Tennis Elbow (Lateral Epicondylitis): Symptoms, Causes, and Treatments

Tennis Elbow

Tennis elbow is an elbow joint condition that affects the muscles and tendons in your arm. It’s caused by repetitive use of your arm, such as when playing tennis. It’s caused by overuse of your arm, and is more common in people who play tennis or other sports that involve using your arm over and over again. It can also be caused by doing everyday tasks that use your arm, such as using a screwdriver or carrying groceries.

Tennis elbow can cause pain and stiffness in your arm and hand. The best way to treat tennis elbow is to rest your arm and take over-the-counter pain medication. You can also try icing the injured area to ease the pain. The good news is that it usually clears up on its own within a few weeks or months. If the pain doesn’t go away, you may need to see a doctor.

There are things you can do to help ease the pain and speed healing. Rest your arm, ice it, and take over-the-counter pain medication if needed. You can also do exercises to stretch and strengthen your muscles and tendons.

Tennis Elbow
Tennis Elbow

Pathophysiology

Pathophysiology of tennis elbow is still unknown, but it is believed that the disease results from a micro trauma to the common extensor tendon. The micro trauma can be caused by repetitive use of the arm and hand, such as in playing tennis. Other physical activities that can contribute to tennis elbow include typing and using a screwdriver. The condition is more common in men than women and usually occurs between the ages of 30 and 50.

The most common symptom of tennis elbow is pain on the outside of the elbow that increases when gripping or lifting objects. There may also be swelling, tenderness, and stiffness in the area. In severe cases, there may be difficulty moving the arm. Diagnosis is made through a physical examination and X-rays may be taken to rule out other conditions.

An article published in 2015 discusses the pathophysiology of tennis elbow The multidimensional nature of this condition should be noted. LE is caused by changes in tendon cellular and matrix structure, changes in nociceptive processing, and changes in muscle function.

Tendon dysfunction: The cellular changes within the tendon are similar to those found in other tendinopathies, according to research. Reactive tendinopathy and degenerative tendinopathy are now viewed as a continuum. It has been discussed previously that tendon pain is no longer viewed as an inflammatory process, and tendinitis is no longer a suitable diagnostic term. The authors discuss how tendons respond to load and how training promotes healing with regards to LE, but they also discuss how tendon cellular and matrix changes result in tendon dysfunction and premature healing. The effects of stress-deprivation on tendons include increases in fibroblasts, decreased longitudinally aligned collagen, and decreased stiffness and tensile strength. In order to improve, we must assess each patient to determine the appropriate level of loading for their tendons.

Pain system changes: In treating tendinosis, there is a large body of research emerging that shows complex central changes occur in these conditions. Therefore, I’m not sure if there is a single condition that does not have an impact on the pain system. This picture summarizes so much about lateral epicondylalgia and is one of my favorites from the NOI group. According to Coombes, Bisset, Vicenzino (2008), “substance P and calcitonin gene-related peptide reactive nerve fibers are located in the proximal ECRB tendon along with small blood vessels. Pain modulators like these are potent! Over the lateral epicondyle, LE patients commonly experience lowered pain thresholds (hyperalgesia) and cold sensitivity (cold hyperalgesia). Despite the fact that thermal pain threshold changes don’t affect as many people with LE, they are an important consideration when assessing more complex cases as you’ll see in the second part of this blog. Motor impairments: Reduced strength and changes in motor control are included in this component.

Researchers such as Jill Cook focus heavily on supination/pronation motor control in their research on tendon flexion/extension strength, shoulder external rotation strength and other key tendon research. As far as pathophysiology is concerned, LE is a multidimensional all condition involving three main components: the muscles affected, the tendon itself, and the local and central nervous systems.