Tennis elbow is inflammation, soreness, or pain on the outer (lateral) side of the upper arm near the elbow. There may be a partial tear of the tendon fibres, which connect muscle to bone. The tear may be at or near where these fibres begin, on the outside of the elbow.
The part of the muscle that attaches to the bone is called a tendon. Muscles in your forearm attach to the bone on the outside of your elbow. When you use these muscles over and over again, small tears develop in the tendon. Over time, this leads to irritation and pain where the tendon is attached to the bone.
This injury is common in people who play a lot of tennis or other racquet sports, hence the name ‘tennis elbow.’ Backhand is the most common stroke to cause symptoms. However, any activity that involves repetitive twisting of the wrist (like using a screwdriver) can lead to this condition. Therefore, painters, plumbers, construction workers, cooks, and butchers are also more likely to develop tennis elbow. This condition may also be due to constant computer keyboard and mouse use.
The main symptom is elbow pain, which gradually worsens with time. The pain radiates from the elbow to the forearm when grasping or twisting. The patient may also develop a weak grasp. The diagnosis is mainly clinical and X-rays are rarely needed.
The treatment initially is to rest your arm and avoid the activity that causes your symptoms for at least two to three weeks. You may also want to:
- Put ice on the outside of your elbow two to three times a day.
- Take nonsteroidal anti-inflammatory medications.
If your tennis elbow is due to sports activity, you may want to:
- Ask about any changes you can make in your technique.
- Check any sports equipment you are using to see if any changes may help.
- Think about how often you have been playing and whether you should cut back.
If your symptoms are related to working on the computer, change your working style to see if it makes a difference. A physiotherapist can show you exercises to stretch and strengthen the muscles of your forearm.
You can buy a special brace for tennis elbow at most pharmacies. It wraps around the upper part of your forearm and takes some of the pressure off the muscles. Your doctor may also inject steroid around the area where the tendon attaches to the bone. This may help decrease the swelling and pain. If the pain continues after six to 12 months of rest and treatment, surgery may be needed.
Olecranon bursitis is inflammation and swelling behind the elbow. It often clears on its own. Treatment may be needed in some cases to reduce the inflammation and clear any build-up of fluid.
Bursitis means inflammation of a bursa. The bursa at the back of the elbow over the olecranon is the most common bursa to become inflamed. Inflammation causes swelling and extra fluid accumulation.
- Mild but repeated injury is thought to be the common cause. For example, people who lean on their elbows a lot, cause friction and repeated mild injury over the olecranon. (Fancy names have been given to this condition when the cause is clear. For example ‘student’s elbow’ when it occurs in people who study with their elbows leaning on a desk. Other names include ‘miner’s elbow’, ‘plumber’s elbow’, etc., when the job involves crawling a lot using elbows.)
- One-off injury such as a blow to the back of the elbow may set off inflammation. If the olecranon bursa is inflamed then it causes a thickness and swelling over the back of the elbow. The bursa may also fill with fluid and it then looks like a small soft ball – a bit like a cyst. Most cases are painless, or are only mildly painful. The movement of the elbow joint is not affected.
- No treatment may be needed. A small painless thickening or swelling is common. It often clears by itself. If a small amount of fluid remains once the inflammation has gone then this can be left alone. However, a large collection of fluid may be unsightly.
- RICE treatment. You may find the Olecranon bursitis (student’s elbow) swelling improves with (R)est, (I)ce packs, (C)ompression (wearing a bandage) and (E)levation (keeping the elbow in a raised position).
- Anti-inflammatory medication may be prescribed to reduce inflammation and swelling.
- A steroid injection into the bursa may cure the problem.
- Aspiration (draining the fluid) can be done with a needle and syringe if a lot of fluid builds up. However, the fluid tends to build up again after being drained. Therefore, you may be advised to wear a tight pressure bandage for a while after the fluid is drained, to prevent it building up again.