EDP column by Professor Ketan Dhatariya
“My GP has told me I have tennis elbow. How can this be the case when I don’t play tennis?”
Tennis elbow is also known as lateral epicondylitis. It is diagnosed when the outer part of the elbow becomes painful and tender, usually as a result of a specific strain, overuse, or a direct injury. Anatomically the outermost part of an area is called ‘lateral’ and the inner most part (i.e. closest to the middle of the body is ‘medial’. The epicondyl is the bony prominence of the humerus – one of the bones in your forearm that make up the elbow. Anything ending in ‘itis’ means it is inflamed. So, ‘lateral epicondylitis’ is an inflammation of the inside prominence of the bone that makes up your elbow.
Lots of muscles attach to this part of the bone. These muscles are important in extending the wrist. Imagine a policeman at some traffic lights using his using his hand to tell a car to ‘stop’. His wrist would be extended. If the muscles become injured in any way, such as by doing a repetitive action, or by over extending the muscles, they can become inflamed and painful.
Your doctor may have tested for tenderness over or near to the bony bump on the outside of the elbow. They would have also tested to see whether the pain gets worse when you bend the wrist back (extend it) against resistance. If you had both of these, it is likely that you have tennis elbow.
If it was the inside of the elbow that was affected, then it would be due to an inflammation of the muscles that attach to the inside of the boney part of the elbow, rather than the outside. That is known as golfers elbow.
The treatment for both is the same, the elbow needs some rest and time for the inflammation to resolve. Painkillers such as paracetamol may help, but the anti-inflammatory drugs, such as ibuprofen are also useful. However, as always, consult your pharmacist or your GP before starting these drugs.
Very occasionally it may be necessary to have a course of physiotherapy may be useful. They may use ultrasound or heat treatments. Often an injection steroids into the affected area to calm the inflammation down.
It can take up to 2 years for the symptoms to resolves, but most get better with a few weeks.
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