Tennis elbow (Epicondylitis humeri radialis)

Tennis elbow (epidcondylitis humeri radialis) is a relatively common condition caused by overuse of a specific tendon. The name of the disease does not indicate that athletes are affected more often, but non-athletes can fall ill just as frequently. For example, musicians, secretaries or domestic workers are equally at risk as tennis players, volleyball players and canoeists. In the course of the disease, tissue changes occur as a result of small tears and inflammations in the tissue, caused by the overload.

Characteristic of the disease is pain at a small bony prominence on the outside of the elbow (epicondylus humeri radialis), as muscles responsible for the movement of the fingers and wrist partially attach here. This pain can sometimes extend into the upper or lower arm.

As already mentioned, the cause of tennis elbow is the overuse of a tendon. Microscopic tears occur in the tendon that connects the muscles to the bones and is responsible for the pain stimulus. As a result, inflammation of the tissue occurs, triggered by this irritation.

People who often make the same hand movement are particularly at risk. This includes, above all, people whose daily work consists mainly of monotonous action sequences in which the hand must grip strongly with the elbow bent (for example, handling a hammer).

Tennis elbow can also be caused by overstraining during sports. Sports such as throwing, tennis, volleyball, canoeing, rowing or shooting are particularly at risk.

The first symptom is pain on pressure in the area of the bony prominence on the outside of the elbow. There may also be muscle pain that starts at the elbow and is responsible for stretching the fingers.

Over time, the pain in the elbow area increases, with an intensification when the wrist is pressed up against resistance. Often there is also a feeling of weakness in the wrist, which is the result of an injured nerve running there. This is the reason why the affected person can no longer grip properly.

The diagnosis can be made after taking a medical history and performing a physical examination. During this examination, the doctor palpates the elbow for areas that may react painfully to pressure.

Imaging techniques can be used to rule out other diseases, such as osteoarthritis.

The first measure for tennis elbow is rest. In the acute stage, cooling promises appropriate relief, while in chronic processes heat contributes to healing. Physiotherapy can be prescribed as a further measure.

If the pain is very pronounced, a bandage worn over the elbow and wrist for a few weeks can help.

Another treatment method is a nerve block in the area of pain, where the nerve conduction is interrupted with a numbing agent.

Among some doctors, treatment using ultrasound, electrotherapy or shock wave therapy is common. However, the chances of cure are controversial and not proven with certainty.

In more difficult cases, surgery is advisable, in which the surgeon incises the tendon at the muscle origin to relieve the tissue.

In acute pain, cooling can be applied with the help of an ice pack. It should be noted that a piece of cloth is placed between the skin and the ice pack, as the ice should not lie directly on the skin. The ideal cooling time is 20 to 30 minutes. After that, a break of about an hour should be taken before cooling can be started again.

In the later course of the disease, the painful areas can also be treated with heat.

Stretching can also be used as a therapeutic measure. This involves extending the elbow fully and turning the forearm inwards. Then the painful hand should be turned to the side until the fingers point outwards. In this position, try to hold the tension for 15 seconds before taking a short break and then starting the exercise again. It is advisable to repeat this exercise several times a day. However, it should be discussed with the physiotherapist or doctor beforehand.

A special bandage (epicondylitis brace) can help with pain relief and healing. This is available in sports shops and medical supply stores.

Anti-inflammatory substances can be used medicinally. These include the classic rheumatism drugs (anti-inflammatory drugs), as well as various herbal preparations, enzymes and nucleotides. Here, the doctor decides which drugs are useful and effective.

The prognosis of tennis elbow is for the most part very good. Often not even an operation is necessary. However, the decisive factor here is how early therapy begins.

The rule is: the earlier, the better the chances of a complete recovery. However, if a patient suffers from symptoms for a longer period of time, an operation may be advisable. It is also very rare that an operation does not lead to an improvement in the symptoms.

Tennis elbow can be avoided by replacing one-sided movements with variety if possible.

Regular stretching of the forearm muscles can also be helpful. To do this, the elbow is stretched, the hand bent backwards and fixed with the other hand. The resulting tension should be held for 15 seconds. This exercise is particularly effective when repeated two to three times a day.