What is tendonitis in the elbow?
Tendons are the soft tissue that connects your muscles to your bones. They are tough but flexible and can be large or small depending on the area of the body. When tendons become inflamed, irritated, or undergo microscopic tears, this is called tendonitis.
A common type of tendonitis is lateral epicondylitis, commonly known as tennis elbow or elbow tendinopathy. Tennis elbow causes pain in the backside of your elbow and forearm. This is due to damage in the tendons that bend your wrist back and away from the palm of your hand.
Symptoms of tendonitis in the elbow
Common signs and symptoms of tennis elbow include:
- Difficulty shaking hands, turning door knobs, or holding objects
- Pain or burning of the outer elbow
- Weak grip strength
Causes of tendonitis in the elbow
Tennis elbow is most commonly caused by overuse and/or muscle strain. Repeated motions and stress may result in a series of tiny tears. These are micro-tears in the tendons that attach your forearm muscles to the bony protrusion at the outside of your elbow, also known as your funny bone.
Playing sports like tennis or racquetball with poor technique is the most common cause of tennis elbow.
Lateral epicondylitis can also occur without any known repetitive injury. This is called idiopathic lateral epicondylitis.
Who gets tendonitis in the elbow?
Tendonitis of the elbow is very common in tennis players and other athletes. Individuals who participate in other activities that require repetitive and vigorous use of the forearm, wrist, and/or hand are also at risk.
Occupations such as auto repair professionals, butchers, cooks, carpenters, painters, and plumbers are all more prone to developing tennis elbow than the average person.
Individuals between the ages of 30 and 50 are more likely to get tennis elbow, but it can occur at any age.
Diagnosis for tendonitis in the elbow
Only a licensed healthcare professional can diagnose tendonitis in your elbow. Your doctor will want to examine your arm in addition to asking about your medical history, occupation, and physical activities.
Your doctor may recommend the following tests to rule out other causes of your elbow pain:
- Electromyography (EMG): An EMG can rule out nerve compression.
- Magnetic resonance imaging (MRI) scan: An MRI can determine the extent of damage in your tendon or rule out other injuries.
- X-rays: An X-ray can provide clear images of the bones of and around your elbow.
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There are several treatments available for tennis elbow. Most patients recover without surgery.
Medications
Over-the-counter pain relief drugs like acetaminophen and Non-steroidal anti-inflammatory drugs (NSAIDs) may help reduce pain and swelling in the elbow.
Home remedies
Your doctor may recommend you do the following:
- Ice: Apply a cold pack or bag of ice with light pressure on your elbow for 15 minutes at a time. You can ice three to four times a day.
- Improve Technique/Form: Ensure that your tennis strokes or other relevant motions adhere to proper form and technique.
- Rest: Avoid any activities or movements that aggravate your elbow tendonitis pain.
Alternative therapies
There are various other non-surgical treatment options for tendonitis in the elbow, including:
- Physical therapy: Physical therapy exercises can help alleviate elbow tendonitis pain. They can also improve your strength, flexibility, and range of motion. Your physical therapist may also perform massage, electrical stimulation, and other techniques to promote healing.
- Platelet-rich plasma (PRP): PRP is a treatment designed to improve the biologic environment of the tissue. Platelets are known for their high concentration of growth factors, which can be injected into the affected area. PRP involves injections of a concentration of the patient's own platelets to accelerate healing.
- Steroid injections: Steroid injections such as cortisone injections are effective anti-inflammatory treatments.
- Using a brace: Using a brace can reduce symptoms by allowing the muscles and tendons of the elbow and forearm to rest.
Another alternative for treatment is called extracorporeal shock wave therapy. It is a relatively new non-invasive therapeutic procedure. This shock wave therapy induces micro-trauma to the affected tissue. The tissue responds to this by healing itself.
Surgery
If your symptoms of elbow tendonitis do not improve after 6 to 12 months of treatment, your doctor may recommend surgery.
The most common surgical approach is called open surgery. This procedure involves making an incision over the elbow to remove the damaged muscle and tissue. Healthy muscle is then reattached to the bone. Open surgery is usually performed as an outpatient procedure.
Tennis elbow can also be repaired using small incisions and tiny instruments with arthroscopic surgery. Like open surgery, it is an outpatient procedure.
Your doctor will work with you to determine the best surgical approach for you.
Harvard Health Publishing: "Tendonitis."
Johns Hopkins Medicine: "Tendonitis."
OrthoInfo: "Tennis Elbow (Lateral Epicondylitis)."
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