Lateral epincondylalgia (tennis elbow) is a chronic musculoskeletal condition that affects the tendon of the wrist extensors at the elbow origin. It most commonly affects the dominant arm particularly when performing repetitive activity.
Who it affects
It most commonly presents in men and women aged between 35 to 54 years and is the most common condition affecting the elbow. Approximately 40% of people will experience tennis elbow at some stage during their lives. Tennis elbow more commonly affects those in manual occupations that involve repetitive arm and wrist movements. It is also associated with office work, older age, being female and previous tobacco use.
The diagnosis and assessment
Diagnosis is based on a patients history and then physical examination. Diagnostic imaging can be useful if trying to determine between two or more different pathologies. If a clinician is confident on the diagnosis of tennis elbow then imaging is not necessary to confirm.
Patient’s usually report an increase in loading prior to the onset of their forearm pain. However the pain may also have an insidious onset without any specific incident or obvious cause.
On physical examination a patient will usually have a presence of pain over the insertion of the common wrist extensors at the lateral elbow. Pain may also radiate into the forearm. Pain is aggravated by gripping, resisted wrist extension (usually when the forearm is extended) and with palpation.
There is emerging evidence that the presence of neck pain is common in patients with tennis elbow. Therefore whilst it may seem unrelated there can be some contribution of pain from the cervical and thoracic spine and will be need to be assessed and treated if any deficiencies are found.
The Clinical Course
Recent reports that suggest that tennis elbow is not a self limiting condition and can persist for many years and that recurrence is common. It has been reported that over 50% of patients that attended a general practice still reported that their elbow pain had not recovered after 12 months.
Conservative management is recommended as the first line treatment for tennis elbow. Treatment will depend on the severity of the presenting condition.
Treatment options can range from education, load management strategies, self management and can also include exercise, mobilisation-with-movements and other passive interventions such as taping.
There is evidence to suggest that corticosteroid injections have a short term benefit on lateral epincondylitis but a negative effect in the intermediate term. Therefore it is not recommended as a treatment option for the management of tennis elbow.
If you are suffering from tennis elbow, or lateral epicondylalgia, book in and consult with one of the physiotherapists at Melbourne Sports Physiotherapy Essendon and Blackburn South to discuss your diagnosis and develop a suitable management plan.
To make a booking to see your local Melbourne physiotherapist for treatment of your Tennis Elbow complaint, please call your local clinic or book online.
Leanne M Bisset, Bill Vicenzino, Physiotherapy management of lateral epicondylalgia, In Journal of Physiotherapy, Volume 61, Issue 4, 2015, Pages 174-181, ISSN 1836-9553, https://doi.org/10.1016/j.jphys.2015.07.015. (http://www.sciencedirect.com/science/article/pii/S1836955315000910)