Tennis elbow (tennis elbow): symptoms and treatment

Tennis elbow (tennis elbow): symptoms and treatment

It is not only people who do a lot of sport who suffer from tennis elbow, more precisely a tennis elbow. Anyone who performs monotonous activities with their arms and hands and puts a lot of strain on the forearm muscles can contract tennis elbow. Typical symptoms include pain on the outside of the elbow. There are several ways to treat tennis elbow, including special bandages or exercises to relieve the pain. But what is needed most is patience. Because it can take several months for tennis elbow to heal completely.

What is tennis elbow?

Tennis elbow, or tennis elbow (radial epicondylitis humeri), is an irritable condition of the elbow characterized by pain. It is caused by an overload of the forearm muscles, which starts at the elbow. The tendon attachments of the muscles in the forearm are irritated and injured by movements that are always the same or are unusually intensive. This can lead to  inflammation  and pain on the outer side of the elbow or even the entire arm.

Tennis elbow occurs in about two percent of the population and is most common between the ages of 40 and 60.

What are the causes of tennis elbow?

Unilateral movements of the forearm and hands can put a lot of strain on the muscles and tendons at the elbow. These include, for example:

  • Sports such as tennis, rowing, badminton or strength training
  • Manual activities such as turning screws, grinding, painting or hammering
  • Operating a computer mouse, keyboard or supermarket checkout
  • Lifting heavy objects, for example when moving house
  • Playing musical instruments such as piano, drums or string instruments

This can lead to small injuries at the insertion of the muscle tendons. In the case of permanent overloading or incorrect loading, there are also signs of wear. All of this eventually leads to inflammation and tennis elbow.

In addition to these causes, tennis elbow can also be triggered by sleeping incorrectly, i.e. by sleeping in the wrong position. This happens, for example, when sleeping on the side, when the arm is bent sharply and used as a headrest.

It is also assumed that pinched nerves or problems with the intervertebral disc in the cervical spine can also trigger irritation in the elbow. Muscular triggers are also possible. If there is constant tension in the muscles in the back, neck or shoulders, this can continue into the arms. This irritates the tendon attachments on the elbow and causes the typical pain.

What are the symptoms of tennis elbow?

The following symptoms are characteristic of tennis elbow:

  • pulling or burning pain on the outside of the elbow (often only when moving or touching the elbow)
  • pain radiating to the rest of the arm and hand
  • Weakness in the arm and thus impairment of everyday activities (e.g. getting dressed or lifting objects)

When should you see a doctor if you have tennis elbow?

If you experience the typical symptoms of tennis elbow, especially pain on the outside of the elbow when you move your arm or touch it, you shouldn’t wait too long before visiting a doctor’s office. The earlier the diagnosis is made and appropriate treatment is started, the better the chances of a quick recovery.

How is tennis elbow diagnosed?

First, the doctor gets a detailed picture of the symptoms. Various questions are asked, for example:

  • When did the symptoms first appear and what exactly do they feel like?
  • In which situations does pain occur: at rest or only when exerting yourself?
  • What professional and sporting activities are carried out?
  • Have you had any injuries or illnesses to the bones of your arms, hands or spine in the past?

The type of pain is particularly important in order to distinguish tennis elbow from other diseases. A bursitis on the elbow is noticeable through a turgid and painful feeling throughout the entire joint. Swelling and redness of the skin may also occur.

Stinging pain as well as a grinding noise when the joint moves are, however, characteristic of tendonitis.< /span> This disease can also be triggered by repeated, uniform movements.

The doctor’s visit also includes a physical examination. The arm is palpated and checked for pressure pain tested around the elbow. It is also checked which movements trigger pain. Various tests can be used to trigger pain from stretching or tension in the muscles.

Zwei einfache, häufig durchgeführte Tests laufen folgendermaßen ab:

  • Den Arm mit der Handfläche nach unten gerade ausstrecken. Mit der Hand gegen einen Widerstand nach oben drücken.
  • Den Arm ausstrecken und die Unterseite des Arms nach innen drehen. Dann wird ein Stuhl an der Lehne (oder ein ähnlicher Gegenstand) mit der Hand angehoben.

Kommt es dabei zu Schmerzen am Ellenbogen, deutet das auf einen Tennisarm hin.

Oft kann eine eindeutige Diagnose schon auf Basis dieser Untersuchungen gestellt werden. Bildgebende Verfahren wie Ultraschall, Röntgen oder Magnetresonanztomografie (MRT) kommen eher selten zum Einsatz. Sie sind dann erforderlich, wenn andere Krankheiten, zum Beispiel ein BandscheibenvorfallArthrose oder eine Schleimbeutelentzündung, als Ursache für die Beschwerden ausgeschlossen werden sollen.

Bandage, Hausmittel & Co.: Welche Behandlung gibt es bei einem Tennisarm?

Ziel jeder Behandlung eines Tennisarms ist es, die Schmerzen zu lindern und eine gewisse Beweglichkeit und Belastbarkeit des Arms zu erreichen. In den allermeisten Fällen reicht eine konservative Behandlung aus. Die konservative Therapie steht der operativen Behandlung (OP) gegenüber und umfasst folgende Methoden, die häufig miteinander kombiniert werden:

  • Schonung des Arms beziehungsweise Verzicht auf Sport: Die gereizten Sehnen und Muskeln sollen in den ersten Wochen nach Beginn der Beschwerden zur Ruhe kommen, etwaige Verletzungen können heilen.
  • Schmerzlinderung durch Kälte- oder Wärmeanwendungen: Dieses Hausmittel ist sehr einfach anzuwenden. Bei akuten Schmerzen kann es helfen, den betroffenen Bereich zu kühlen. Besteht der Tennisarm schon länger, hat es sich bewährt, diesen zu wärmen. Dadurch wird die Durchblutung gefördert und die Muskeln können entspannen.
  • Medikamentöse Schmerzlinderung: Schmerzmittel wie nicht-steroidale Antirheumatika (NSAR), dazu gehören Ibuprofen und Diclofenac, können kurzzeitig eingenommen werden, um die Schmerzen zu lindern und eine Entzündung zu hemmen.
  • Salbenverbände: Auch mit entzündungshemmenden und schmerzlindernden Salben kann ein Tennisarm behandelt werden. Die Salben können einmassiert oder in Form eines Salbenverbands über Nacht aufgebracht werden.
  • Spange: Die sogenannte Epicondylitis-Spange ist ein elastisches Band mit einem Druckpolster. Dieses wird auf den schmerzenden Bereich der Außenseite des Ellenbogens angebracht. Es kann die Durchblutung fördern und zu einer schnelleren Heilung beitragen.
  • Manschette: Ähnlich wie die Spange wird eine Manschette am Ellenbogen mit Klettversschlüssen angebracht. Die Manschette soll den Ellenbogen entlasten und die Heilung unterstützen.
  • Taping: With the help of a tape (kinesiotape) that is stuck to the arm, the overloaded forearm muscles and the tendon strands are supposed to be relieved and stabilized.
  • Bandage: The tennis elbow bandage (elbow bandage, also called orthosis) can be worn to prevent tennis elbow and to prevent a relapse. It stabilizes and relieves pressure on the elbow – but whether it is helpful for acute complaints is scientifically controversial.
  • Massage: With a special massage technique, the so-called transverse massage (transverse friction), the muscles and tendons are mobilized in physiotherapy and adhesions are released.
  • Ultrasound treatment: By irradiating the arm with ultrasound waves, the tissue is heated, which stimulates blood circulation and supports the healing process.
  • Extracorporeal shock wave therapy (EWST): Short, high-energy shock waves are intended to stimulate blood circulation and the body’s own healing of the tendons.
  • Stimulation current treatment (iontophoresis): Another option is to treat the pain with stimulation current. It is possible that the current inhibits the transmission of the pain stimulus from the source to the brain.
  • Injections: In the doctor’s office, anti-inflammatory medications such as  can be given Cortisone or painkillers are injected directly into the affected area of ​​the arm. The symptoms often improve immediately. However, the treatment is painful. Infections or tendon damage can also occur.

Surgery is only recommended if conservative treatment has not improved the symptoms even after six months. To relieve the strain on the tendon, it can be notched. Additionally, it is possible to cut the nerve that is responsible for the pain. However, so far there has been little research into whether surgery on tennis elbow is really beneficial.

There are also numerous exercises to stretch and strengthen muscles and tendons. These can easily be done at home following instructions.

Treat tennis elbow with exercises

Regular exercise is an important part of treating tennis elbow. Light, eccentric training (i.e. stretching and lengthening the muscles) should be carried out every day for a period of three months without putting too much strain on the arm. It serves to stretch the extensor muscles in the forearm – which are not only irritated with tennis elbow, but also usually shortened due to the tendons growing together – at the same time to strengthen. This can reduce pain and speed up the healing process. Pure stretching exercises help to improve the mobility of the arm and wrist.

Exercise 1: eccentric training

The following exercise can help with tennis elbow:

  1. Take a small, light dumbbell or a suitably filled water bottle in your hand.
  2. Place the affected arm on a table and let the hand with the dumbbell hang over the edge of the table. The back of your hand should point upwards.
  3. Use your other, free hand to help lift the dumbbell upwards as far as you can.
  4. Then slowly lower the hand holding the dumbbell.

You should repeat this exercise 10 to 15 times and, after a short break, do two more sets. Be careful to avoid straining your arm.

Exercise 2: Stretching

This exercise is also suitable for improving symptoms:

  1. Extend the affected arm straight forward so that the back of the hand is facing upwards.
  2. Release your wrist so that your hand falls down.
  3. With your other hand, gently pull the hand of the affected arm toward your body. The arm remains stretched.
  4. You should feel a stretch at the top of your forearm.
  5. Hold this stretch for about 30 to 45 seconds.

After the exercise, you should rest for 30 seconds and then perform three repetitions.

Sick note: Can you work with tennis elbow?

Whether you can and are allowed to work with tennis elbow depends on various factors – including what job you do and how severe the symptoms are. These vary greatly from person to person, which is why no general statement can be made about the duration of a sick note.

It is usually the case that activities and movements that put strain on the arm should, if possible, be avoided for a certain period of time until the acute symptoms have improved. This is particularly important for groups of people who work a lot with their hands and arms, or for whom the symptoms of tennis elbow only arise from overwork at work.

It is best to make an appointment at a doctor’s office to discuss treatment options and what to do next.

Tennis elbow, golfer’s elbow or mouse elbow: what’s the difference?

In contrast to tennis elbow, where the pain occurs mainly on the outside of the elbow, so-called  golfer’s elbow,  or golfer’s elbow, causes symptoms on the inside of the elbow. However, the treatment of both diseases is very similar.

With the  mouse arm  , the pain mainly occurs in the hand, wrist and forearm. A mouse arm is due, among other things, to constantly repeating movements when working with the computer mouse. It is also known as RSI syndrome (RSI = Repetitive Strain Injury).

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