Tennis elbow

Tennis elbow is a condition that causes pain around the bony part on the outside of the elbow, and the pain can travel down into the forearm. You may also hear it called lateral epicondylitis or lateral epicondyle tendinopathy.

It most often affects the dominant arm. In many cases it's an overuse injury, caused mainly by repeated strain from tasks and activities that involve gripping again and again and moving the hand.

The name comes from the fact that it's a common injury in racquet sports. But many other activities can bring on tennis elbow too.

Tennis elbow causes pain and tenderness on the outside of your elbow, and the pain may spread down your forearm. You may notice:

• difficulty with gripping.
• difficulty with twisting movements such as opening jars.
• restriction in movement at the elbow.
• tenderness when touching the area.

Tennis elbow symptoms start when something goes wrong with the tendons around the elbow. These tendons help you lift your hand backwards.

Many everyday activities use these tendons, including:

• gripping
• writing
• lifting
• pulling
• twisting

If you use the muscles that lift your wrist up again and again, the tendon can change, often because it has been overloaded.

Some other things can also affect the health of your tendons:

• smoking
• obesity
• a high fat diet
• high cholesterol levels
• diabetes (Type 1 and 2)

A doctor needs to assess you before tennis elbow can be diagnosed. They'll start by asking you about the problem with your elbow, and then they'll examine it. This may include checking how far you can move the elbow and how strong it is.

Sometimes you may need a further examination, so the doctor can rule out other possible health conditions.

If certain movements make your elbow pain worse, try to cut down on them by changing how you do things. You can do this by:

• changing how you grip or lift an object.
• reducing the weight you are carrying.
• taking regular breaks while doing the activities that bring on the pain.

Changing your activities is one part of it, but you should also start exercising your elbow.

Pain medicine can help you move more comfortably, and that in turn helps you manage the symptoms of tennis elbow.

Some people find an elbow support, sometimes called an epiclasp, useful for the pain tennis elbow causes. Research suggests these supports may help in the short term, but the evidence for using them is limited.

If exercise, changing what you do with your arm and painkillers aren't controlling the pain, your doctor may talk to you about a corticosteroid injection into the elbow. The current evidence shows only limited benefit for this type of condition, and the injection may harm the health of your tendon. Corticosteroids are medicines that help reduce pain and inflammation. They may also be given with a local anaesthetic. An injection won't cure the condition. It is used only to help with the pain.

With tennis elbow, you may sometimes need to take some time off work so you can recover. How long you stay off depends on your condition and on the kind of work you do.

You don't have to be free of symptoms before you think about going back. Carrying on with work, or returning as soon as you're able, will help your recovery.

Getting back to your normal daily activities bit by bit can also help you build up your strength and stamina.