Elbow pain: Lateral Epicondylitis (aka, Tennis elbow)

The technology boom of the past decade has not only made our lives easier (debateable), but also caused a surge in overuse injuries. Smart phones, i-pads, and laptops (to name a few) have become as common TV’s and cars to every household in America. The age of instant access to information and social media has made keeping up with news, family and friends much easier but has come at a price. Elbow pain, specifically Lateral Epicondylitis, and Carpal Tunnel syndrome (a topic for another day) have become more common and can become extremely debilitating if not treated in a timely manner. Keep in mind that it can take as little as 3 weeks for an injury to become chronic and therefore seeking early intervention can literally be the difference in a successful outcome and months of pain and discomfort. Unlike most injuries, Lateral Epicondylitis is a problem that almost anyone can diagnose, as long as you know what signs to look for.

First, What is Lateral Epicondylitis? Simply stated, lateral epicondylitis is overuse tendonitis of the wrist and finger extensors. Pain and discomfort are felt on the outside of the elbow and can run down the forearm into the various muscles (muscles that make up the back of the hand). The muscles on the back of the wrist are very small and they all come together and insert just above the elbow.

Second, What are the symptoms? 1. Tender to touch, just above the elbow on the back of the forearm. The area will definitely be sore due to the inflammation. 2. Pain with picking up weighted objects such as a jug of milk, coffee cup, etc., and even something as simple as typing on your laptop. The pain noted in this area can run the entire gammit from sharp pain to a dull, achy feeling. The pain generally subsides when the affected hand is at rest. 3. Noted weakness. Noticeable weakness with gripping activities along with pain in the above mentioned area is a sure fire indicator that you may have lateral epicondylitis. It is not uncommon for me to have patients tell me that they have problems with dropping objects (usually making a mess). 4. Pain with resistance. Make a fist on the hurt arm. Push down on the back of the affected hand with the uninjured hand and that can elicit pain in the elbow. If all these symptoms are present, BAM, you have just acturately diagnosed yourself with Lateral Epicondylitis.

Now I know you are extremely proud of yourself and you should be but ultimately I’m sure you really just want to stop hurting. Let’s talk about the important stuff, the steps to recovery. What to do: 1. Ice. But you say, I hate ice. Believe me, early on, ice is your friend. Putting an ice pack on the painful area for 15 minutes 4-5 times a day greatly enhances your chances of saving a copay. 2. Medication. My medication of choice is Aleve. 2 in the morning and 2 at bedtime for a week is where I generally start. Ibuprofen or Motrin is an acceptable substitute. These medications are called NSAIDS and can be affective at fighting muscular inflammation. If you are unable to take NSAIDS, consult your physician for alternative medications. 3. Rest. It’s simple but true. Making a conscious effort to limit the use of the affected hand greatly improves your chance of success. Trust me, I get it. This is easier said than done, but if you don’t use the affected arm, it won’t hurt. Continuing to use the injured arm increases the inflammation in the tendons and delays healing. 4. Bracing. I struggled with whether or not to mention tennis elbow braces but I do feel they can help manage your pain but here is my disclaimer. Make sure you use them correctly. Proper application is key. If you are unsure of how to properly apply the brace, seek assistance from a qualified health care provider.
In conclusion, Lateral Epicondylitis is not something that you have to run to the doctor with. We mentioned that time is important and it is but give yourself 1 week of managing your symptoms with these simple steps and if the pain improves, then give yourself another week, if it doesn’t, seek the advice and counsel of your family physician. Remember, early intervention and treatment is important to kicking that unwanted uncle out of the house before he wears out his welcome.

This article was written by one of our PT, ATC, Matt Moorer.