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Playing tennis is not the only way to get tennis elbow

Dear Doctor: My uncle tells me he was diagnosed with “tennis elbow.” That is odd; he has never played tennis a day in his life. What is tennis elbow?

The muscles in your hand and arm are attached to the bone near the elbow. The thick, fibrous portion of the muscle that attaches directly to the bone is called the tendon. When the connecting tendons become irritated or inflamed, the condition is called tendinitis.

The area can become exquisitely tender, swollen and painful. Tendinitis can affect any joint. This includes the shoulders, elbows, knees, wrists, heels and other joints. Other names for tendinitis of other joints include swimmer’s shoulder, jumper’s knee and golfer’s elbow (located on the inner elbow).

Tennis elbow is a form of tendinitis affecting the outer portion of the elbow. The medical term for tennis elbow is “lateral epicondylitis.” Of course, any repetitive overuse of the elbow or muscles of the hand can cause the condition, not just playing tennis.

Causes of tendinitis

Usually, tendinitis is caused by repetitive motions that overuse and produce stress and strain on the tendons. Tendinitis most commonly occurs over time rather than due to an acute event. The condition is a result of overuse of the muscles or tendons.

Activities known to produce tennis elbow include but are not limited to: painting, carpentry, cooking, using scissors, weight lifting, auto repair, raking, extensive keyboard and mouse use, racquet sports, extensive or repetitive hand-shaking (greeting), repeated medical injections (using a squeezing hand motion), and other repetitive activities involving the wrist and forearm. The most commonly involved muscle or tendon producing tennis elbow is inflammation of the extensor carpi radialis brevis.

Symptoms of tendinitis

Pain, swelling and tenderness of the lateral elbow
Pain in the elbow when gripping items firmly with the hand
Pain when moving the joint or limb
Weakness in hand grip

Diagnosis of tendinitis

Diagnosis is made by the appropriate history of forearm use, physical examination by a doctor, and imaging studies such as X-rays and MRI. Also, nerve compression studies may be used to assess any nerve damage.

Treatment of tendinitis

There is no perfect treatment for tennis elbow, but there are many approaches that can be tried, and many can make a significant improvement. These include:

Pain relievers
Stretching
Physical therapy
Ice
Rest
Compression or brace
Decrease in activities that are repetitive and causative
Anti-inflammatory medicines
Steroid injections
Surgery
Platelet-rich plasma injections

One of the new and more promising treatments for tennis elbow is platelet-rich plasma (PRP). This involves locating platelets and other healing proteins or factors from a patient’s own blood and injecting it back into the area of concern. There are many promising studies that show PRP therapy may be one of the most promising and effective treatments for tennis elbow.

If you suspect that you may have tennis elbow, see your doctor for the accurate diagnosis. Then review all the treatment options. Together you can select the best treatment plan for you.

Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.

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