Lateral epicondylitis, which is a form of tendinitis, is a musculoskeletal condition that frequently affects men and women between the ages of 35 and 54, and impacts approximately 1 to 3% of the general population.
Manual workers and racquet sports, especially tennis players, are more at risk, hence the common name, tennis elbow. It is also called external epicondylitis or lateral epicondylitis.
It is the result of micro-traumas, following a repetitive movement, to the tendon of the extensor muscles of the wrist, which attaches to the external epicondyle of the elbow (the bony prominence of the outer side of the elbow).
It is different from medial/internal elbow tendinitis, epitrochleitis or golfer’s elbow, which is a condition of the flexor muscles of the wrist and fingers.
What are the causes of epicondylitis?
Lateral epicondylitis can occur in two ways: as a result of trauma or, more often, as a result of overuse of the muscle.
Certain factors may be particularly at fault, such as the execution of jerky movements (throwing), or excessive gripping (grabbing and holding an object), or rotation and/or extension movements of the forearm.
Regarding sports, and more specifically racquet sports, poor technique could also lead to tennis elbow, for instance a poor grip on the racquet, an improper stroke pattern (taking the ball too early), or mistakes in centering the ball.
However, tennis elbow is not limited to sports activities, as it also affects many professionals. Elbow tendinitis particularly affects people who work in front of a computer, with a poorly adapted workstation (computer mouse).
Carrying heavy loads is also a risk factor, as is a lack of rest time for the joint.
Depending on its severity, it can heal in 6 weeks to 12 months. If it persists for more than 12 months despite conservative treatment, surgery may be considered.
What are the signs and symptoms of lateral epicondylitis/elbow tendinitis?
The main symptom of lateral epicondylitis is pain on the outside of the elbow, around the bony prominence, and along the muscles leading to the wrist.
Various signs are characteristic of lateral epicondylitis, including increased pain and tenderness:
- On palpation or when touching the outside of the elbow;
- When resisting the upward movement of the wrist;
- When squeezing an object with your hand.
You may also experience a decrease in grip strength and joint mobility.
How to treat elbow tendinitis quickly? Hot or cold? Natural treatment
It is recommended to avoid the movements that cause the pain as much as possible and to gradually increase the level of effort required from the tendon.
When symptoms appear, if you feel pain on the outside of the elbow or when moving the joint, the first thing to do is to limit as much as possible the activities, movements or gestures that lead to pain.
If your professional activity is the issue, you may want to take a leave of absence. As this is not always possible, try to take regular breaks and to stretch.
If you practice a sport, stopping or reducing your activity may be recommended until the inflammation subsides.
It is important to note, however, that rest should be partial, not complete. Keep your muscles mobile as much as possible, following your tolerance.
Applying ice or heat may also be an option if it helps. However, be careful not to apply it directly to the skin, to avoid burning or irritating it.
When the pain subsides, gradually resume your activities, increasing the load as you go.
The natural treatment may have its limitations. It is recommended that you consult a healthcare professional as soon as symptoms appear. A physiotherapy treatment plan may help you with the healing process.
How to treat and heal elbow tendinitis/epicondylitis? A closer look at physiotherapy
Physiotherapy treats elbow pain. It is available in direct access, which means that you do not need a prescription to make an appointment.
A physiotherapy follow-up always begins with an evaluation to determine the extent and severity of your injury. Your physiotherapist will be able to teach you the appropriate progression of exercises, but first, he or she will confirm that it is indeed epicondylitis.
Physiotherapy treatment will be tailored to your condition and will include manual therapy, Cyriax friction, eccentric strengthening and myofascial stretching to accelerate healing.
You will also be prescribed strengthening and stretching exercises. Ice can also be effective in reducing pain. Ergonomic work posture and taking breaks will help reduce stress on the forearm muscles.
Depending on your condition, your doctor may prescribe anti-inflammatory drugs (NSAIDs), a corticosteroid injection, a resting brace or epicondylar band to reduce pain and overload in the tendon, or a platelet-rich plasma (PRP) injection.
If you experience any of the above signs and symptoms or if there is no improvement within a few days of the onset of pain, consult your physiotherapist promptly. The longer it takes to consult your physiotherapist, the more demanding the rehabilitation will be.
Splint, orthosis, epicondylial bracelet… what are the recommendations?
In the case of external epicondylitis, wearing an orthosis, commonly called an epicondylar brace, can be effective. Its purpose is to limit the stress inflicted on the tendon of the extensor muscles of the wrist, and thus, thanks to rest, to help reduce the pain.
However, it is important to understand that an orthosis is not a treatment on its own, and that it should not replace a treatment. It should be used as a complement.
You should consult a healthcare professional so that he or she can recommend an orthosis tailored to your condition. In some cases, the use of a brace may aggravate the symptoms.
In which cases can you consider surgery?
Surgery for lateral epicondylitis is used as a last resort when conservative treatments and/or infiltrations have failed.
Surgery will consist of removing or reducing the tension in the tendon of the wrist extensor muscles by relaxing them.
Warming up, stretching: how do you prevent tennis elbow?
It is not always possible to prevent the onset of tennis elbow, but a few good habits can help minimize the risk.
For instance, warming up should be an integral part of sports practice.
It is also essential to take breaks while exercising so you don’t put too much stress on your tendons.
If it makes you feel better, you can stretch after the sport.
Strengthening the extensor muscles through physiotherapy can also be a good option. Indeed, physiotherapy can be a useful tool in the prevention of injuries.
Do not let a discomfort turn into pain before consulting a physiotherapist, and make an appointment directly on our website. The therapist will be able to identify the cause of your discomfort and treat it.