Tennis Elbow

 

Introduction

Tennis elbow, medically known as lateral epicondylitis, is a condition that affects many individuals, not just athletes. Despite its name, it often arises in people who have never played tennis. It occurs when the tendons in the elbow become irritated, typically due to overuse or repetitive strain. The condition can lead to pain and discomfort, often limiting the ability to carry out daily tasks.

At Alton Pain Clinic, our clinicians frequently see patients experiencing tennis elbow, and we aim to provide an in-depth understanding of the condition. This blog explores its causes, symptoms, anatomy, diagnosis, and various management approaches, including the use of ultrasound-guided steroid injections as one of the treatment options we provide.

Anatomy of the Elbow

To understand tennis elbow, it helps to first appreciate the elbow’s anatomy.

• The elbow joint connects the humerus (upper arm bone) with the radius and ulna (forearm bones).
• At the outer side of the elbow, the lateral epicondyle of the humerus serves as an attachment point for the forearm’s extensor tendons.
• The extensor carpi radialis brevis (ECRB) tendon is most often implicated in tennis elbow.
• These tendons help control wrist and finger movements, particularly extension.

When these tendons are repeatedly overloaded, microscopic tears can occur, leading to pain and dysfunction.

Causes of Tennis Elbow

Tennis elbow usually results from overuse or repetitive strain rather than a single injury. Some common causes include:

• Repetitive wrist and arm movements — common in certain occupations such as carpentry, painting, typing, or plumbing.
• Sports-related strain — particularly racquet sports such as tennis, squash, or badminton, where improper grip or technique can overload the extensor tendons.
• Everyday activities — gardening, lifting heavy shopping bags, or even prolonged computer use.

It is important to note that while sports may contribute, many cases develop without any athletic involvement.

Symptoms

The most frequently reported symptoms of tennis elbow include:

• Pain and tenderness on the outer part of the elbow, particularly around the lateral epicondyle.
• Radiating discomfort into the forearm and wrist.
• Weak grip strength, often noticeable when holding objects such as cups, tools, or pens.
• Pain during activities involving wrist extension, such as opening jars, shaking hands, or lifting objects.

The symptoms may develop gradually, becoming more noticeable over weeks or months.

Risk Factors

Certain factors may increase the likelihood of developing tennis elbow:

• Age — most common between the ages of 30 and 50.
• Occupation — jobs requiring repetitive arm and wrist motions.
• Sports — particularly racquet sports with poor technique or overuse.
• Repetitive strain activities — hobbies such as DIY, knitting, or musical instruments.

Diagnosis

A diagnosis of tennis elbow is typically made through clinical assessment. At Alton Pain Clinic, our clinicians carefully evaluate symptoms and carry out a physical examination. Key steps may include:

• Palpation — pressing on the lateral epicondyle to check for tenderness.
• Resisted movements — asking the patient to extend their wrist or fingers against resistance, which may reproduce the pain.
• Range of motion tests — ensuring that the elbow joint moves smoothly.
• Imaging — ultrasound may be used to assess tendon changes or rule out other causes.

Management Approaches

The management of tennis elbow often involves a combination of strategies tailored to the severity and persistence of symptoms.

Rest and Activity Modification

Reducing or adapting repetitive movements can help minimise strain on the tendon.

Ultrasound-Guided Steroid Injections at Alton Pain Clinic

For individuals with persistent symptoms, an ultrasound-guided steroid injection may be considered. At Alton Pain Clinic, this procedure is carried out by experienced clinicians.

• Ultrasound guidance ensures accurate delivery of the injection directly to the affected tendon area.
• The use of ultrasound allows real-time visualisation, helping improve precision.
• Steroid injections are generally aimed at reducing inflammation and pain, thereby allowing better participation in physiotherapy and daily activities.

While no single approach is suitable for everyone, injections may be a helpful option within a broader management plan.

Recovery and Prognosis

The course of tennis elbow varies from person to person. Some individuals recover within a few weeks, while others may require longer-term management. Early recognition, rest, and appropriate intervention can help support recovery and prevent the condition from becoming chronic.

Preventive Strategies

To reduce the risk of developing or worsening tennis elbow, the following strategies may be helpful:

• Using correct technique in sports such as tennis or badminton.
• Ensuring ergonomic positioning at workstations.
• Taking regular breaks during repetitive tasks.
• Strengthening forearm and wrist muscles through targeted exercises.

Why Choose Alton Pain Clinic

At Alton Pain Clinic, our clinicians are highly experienced in managing musculoskeletal conditions such as tennis elbow. We provide:

• Specialist assessment and diagnosis tailored to each individual.
• Ultrasound-guided procedures, ensuring precision and safety.
• A personalised approach that may include injections, physiotherapy referrals, and advice on lifestyle modifications.

Our aim is to support patients in understanding their condition and accessing appropriate care.

Conclusion

Tennis elbow is a common yet often misunderstood condition. It arises from repetitive strain on the extensor tendons of the forearm, leading to discomfort and difficulty with everyday activities. While rest, physiotherapy, and lifestyle changes play an important role, some individuals may benefit from ultrasound-guided steroid injections as part of their management plan.

At Alton Pain Clinic, we are committed to providing tailored, evidence-based approaches for patients experiencing musculoskeletal pain. By combining expertise with advanced ultrasound techniques, our clinicians help guide patients through safe and effective options for managing tennis elbow.