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Guide to Tennis elbow

What is a Tennis elbow?

Tennis elbow is a common donation that occurs in the elbow. It is located on the outside aspect of the elbow and is usually described as a sharp and burning ache. The symptoms present themselves over time and are often ignored until the pain becomes unbearable. Here are some of the common symptoms that you may experience with tennis elbow:

  • Pain while typing
  • Pain with lifting or gripping items
  • Onset of pain while using the fingers repeatedly
  • Pain while making a fist
  • Tenderness and pain felt around the outside of the elbow

What causes a Tennis elbow?

The main attributing factor that leads to tennis elbow is repetitive overuse of the wrist extensor muscles causing micro-tearing of the tendon that leads to failed healing and subsequent degeneration. It occurs in tennis players due to the repeated extension movements they place their wrists in while playing. Over time repeated tendon irritation and tears cause it to become thickened and worn leading to tennis elbow or medically known as lateral epicondylitis.
Just because you don’t play tennis doesn’t mean you can’t develop tennis elbow as it can affect anyone who uses their wrists and fingers such as office workers, builders and gym-goers.

How is a Tennis elbow diagnosed?

The diagnosis of tennis elbow will be based on the presenting symptoms and the completion of a complete physical examination which will include, orthopaedic, neurological and range of motion assessments. There are a few special tests that if positive may indicate the presence of a tennis elbow. If required the practitioner may refer you to get an ultrasound scan done to evaluate the extensor tendon for any signs of tearing or tendinitis (inflammation).

How is a Tennis elbow treated?

Unfortunately, tennis elbow is slow to recover from and usually starts with conservative care. Initially, patients require selective rest and avoidance of activities that involve the repetitive extension of the wrist. Ice massages can be helpful to perform at home but do nothing in the long-term course of chronic pain relief. Some of the treatments that can be provided are myofascial therapy, stretching exercises and activity modification.

Another form of treatment is the use of extracorporeal shockwave therapy which is an effective treatment option used to treat tendon pain. This is done by desensitising irritated nerve endings and by causing micro-trauma, triggering a healing response of the tendon.

Another form of treatment would be the use of Ultrasound-guided steroid injection into the site of pain.


Bigorre N, Raimbeau G, Fouque PA, Saint Cast Y, Rabarin F, Cesari B. Lateral epicondylitis treatment by extensor carpi radialis fasciotomy and radial nerve decompression: Is outcome influenced by the occupational disease compensation aspect?. Orthopaedics & Traumatology: Surgery & Research. 2011 Apr 1;97(2):159-63.

Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. Bmj. 2006 Nov 2;333(7575):939.

Bishai SK, Plancher KD. The basic science of lateral epicondylosis: update for the future. Techniques in Orthopaedics. 2006 Dec 1;21(4):250-5.

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