Dr. Manpal Singh Narula
Tennis elbow(कोहनी का दर्द): Symptoms, Causes, Diagnosis & Treatment
In this video SimpliHealth exert Orthopaedic Spine and joint Dr. M.S Narula is talking about a critical common condition that experts frequently encounter in OPD: Tennis elbow(कोहनी का दर्द). You must have heard this commonly used term
What is this tennis elbow(कोहनी का दर्द)?
It is a condition that is medically known as lateral epicondylitis. This pain occurs in the outer portion of the elbow. This pain may start from the elbow and come down to the forearm, so the pain which happens in the elbow is called a tennis elbow.
Tennis elbow Causes and Diagnosis
The history of tennis elbow is reported by the patients as a pain which happens when they are doing a particular activity like they pick something heavy like a bag or suitcase. Ladies complain that when they wring the clothes to squeeze out water in that position or pick a pan, it starts paining severely . So it is termed as tennis elbow because during tennis, players use a very heavy racket, and especially those who play with the back hand, their muscles get strained, it hurts, and that’s how the name Tennis elbow derives its name
In addition, there is also another condition which is a golfer’s elbow. It is similar to the tennis elbow, but this pain comes from the inner area of the elbow. Often, patients complain that when they pick up something, it starts paining from inside; this is called a Golfer’s elbow. And this is tennis elbow. There are wrist muscles. If you see the wrist muscles help in an upward movement. If they move their wrist a little upwards, there is movement in elbow muscles. So all these muscles help in grip and attach themselves here (elbow).
So in the overuse injury, which means when we use that muscle repeatedly, like picking up something heavy, that muscle which is attached to bone, comes under strain, sometimes it may result in a tear also, and there is inflammation; that’s why it hurts on the outer side of the elbow. Hence it’s called a tennis elbow. Its history is very typical; as our experts toldtell,m,,lk you, it hurts when patients pick up things from the overhand grip, like picking up the pan or bag, especially those who lift weights in the gym. When they pick up anything in this position it starts hurting.
From its history, we can diagnose that it is a tennis elbow. We perform some clinical tests like asking the patient to move their wrist against resistance and or we put a stretch on their wrist; the pain can be seen on the elbow. It is a simple clinical diagnosis. We don’t require an X-ray as this is a muscle and tendon problem. It doesn’t come in an X-ray. In a rare case, an MRI is done. It’s a clinical diagnosis, and it’s a very straightforward diagnosis.
Which category of people suffer most from this problem? As I told you, this is an overuse or repetitive use injury. It happens when ladies wring the clothes to squeeze water or while picking up a heavy pan. or men who take a heavy bag while they are traveling, lift heavy bags or when tennis players make frequent use of the backhand. Also, weightlifters bodybuilders, while using their hands to grip the weights can also be affected.
Treatment for tennis elbow
Initially, when the pain begins, we prescribe mild anti-inflammatory or pain killers to patients. One can do icing to avoid inflammation. We often advise the patients to not do that particular activity that causes them pain. Most importantly, a patient should not pick up things with the overhand grip. Pick up like this. It strains our elbow muscles when we pick up stuff from the overhand grip. So we need activity modification, painkillers, and little icing to get relief in the initial stages. Also,a brace called a tennis elbow band can be placed around for relief. In the initial stages this treatment is enough. Suppose a patient doesn’t respond to this treatment an injection is given in his elbow.
It is a very safe and effective treatment. One injection heals the entire pain. It is a locally active steroid. Only one injection does the work. Still, we may repeat this injection in a few cases after one month. The injection is usually given in these areas; it’s just a steroid mixed with local anesthesia. Most of the time it works very well and a patient does not require any further treatment. Less than 5% rather less than 2% cases require surgery for this. But that is very rare. Most people respond to the conservative treatment, which includes an initial period of anti-inflammatories followed by Physio.
As our experts previously mentioned, there is muscle strain, so we recommend Physiotherapy in these patients. To strengthen these muscles, gradual stretching is essential. Physiotherapy combined with injections works in most conditions. So if you are having chronic or recurrent pain on the outer portion of your elbow or in the inner side of the elbow, you must consult your Orthopaedic surgeon.
Don’t fear the injections if you are not getting relief from the routine anti-inflammatory. Please get it done. It is one hundred percent curable. Stay safe, happy, and healthy. Thank you very much.