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TENNIS ELBOW

(LATERAL EPICONDYLITIS)
Tennis Elbow

WHAT YOU NEED TO KNOW:

What is tennis elbow? Tennis elbow is inflammation of the tendons in your elbow. Tendons are strong tissues that connect muscle to bone.

What causes tennis elbow? Tennis elbow is caused by overuse of the muscles in your forearm. These muscles are used to straighten your arm or lift your hand and wrist. Fast, repeated arm movements can lead to inflammation and small tears in your tendon. Tennis, painting, and manual labor are common activities that can cause tennis elbow.

What are the signs and symptoms of tennis elbow?

  • Pain when you straighten your arm or rotate your wrist and forearm outward

  • Weakness in your wrist or hand

  • Trouble holding, lifting, or grabbing an object, such as a coffee cup

  • Tenderness on the outside of your elbow

  • Red, swollen, warm skin on the outside of your elbow

How is tennis elbow diagnosed? Your healthcare provider will feel around your elbow to check for painful areas. He will check the movement of your elbow, wrist, and fingers. You also may need the following:

  • X-ray: This is a picture of the bones and tissues in your elbow. It is used to check for a fracture or arthritis. Dye may be injected into your joint before the x-ray. This will help your joint show up better on the monitor.

  • Ultrasound: This test uses sound waves to show pictures on a monitor. It is used to show if you have tears in your tendon or fluid around your elbow joint.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your elbow. An MRI may show tears in your tendons and ligaments. Ligaments are strong tissues that connect bones together. You may be given dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is tennis elbow treated?

  • Support devices: You may need an arm strap, brace, or splint to limit your arm movement. These devices help decrease pain and prevent more damage to your tendon.

  • Medicines:
    • Acetaminophen: This medicine decreases pain and fever. You can buy acetaminophen without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

    • NSAIDs: These medicines decrease swelling, pain, and fever. You can buy NSAIDs without a doctor's order. Ask your healthcare provider which medicine is right for you, and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.

    • Steroid injection: This shot will help decrease pain and swelling.

    • Botox injection: This shot will help decrease pain and help your muscles and tendons rest and heal.

  • Physical therapy: A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain.

  • Surgery: You may need surgery if your symptoms do not improve with other treatments. During surgery, your healthcare provider will remove any damaged tissue. He may also cut your tendon and reattach it.

How can I manage my symptoms?

  • Rest: You may need to rest your injured arm and avoid activities that cause pain. This will help your tendon and muscles heal.

  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel and place it on your elbow for 15 to 20 minutes every hour as directed.

  • Elevate: Raise your elbow above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your elbow on pillows or blankets to keep it elevated comfortably.

What are the risks of tennis elbow?

  • You may have an allergic response to the medicines used to treat tennis elbow. Steroid shots may cause pain, changes in your skin color, and fat loss in the area of the shot. Steroid shots may also weaken your tendon and increase the risk for tendon rupture. Botox shots may cause finger numbness and weakness. Surgery may cause you to have pain, swelling, and bruising. Surgery may also cause nerve damage and lead to numbness in your elbow or forearm. New bone may form in abnormal areas around your elbow as the area is healing. Even after treatment, you may still have pain and weakness in your elbow, wrist, or hand.

  • Without treatment, you may have long-term pain. You may not be able to grab, squeeze, or lift items with your injured hand and arm. It may be hard to do your daily activities.

When should I contact my healthcare provider?

  • You have a fever.

  • You have more pain or weakness in your arm, wrist, hand, or fingers.

  • You have new numbness or tingling in your arm, hand, or fingers.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You suddenly have no feeling in your arm, hand, or fingers.

  • You suddenly cannot move your arm, wrist, hand, or fingers.

  • Your elbow or arm are red, warm, and swollen.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.