Tennis Elbow (lateral epicondylitis) is caused by tendonitis or swelling around the tendons on the outside edge of the elbow. It is called tennis elbow because it’s caused by an injury to elbow from movements used in racket games like tennis. As a result, often people suffering from lateral epicondylitis have it from playing tennis. However anyone can suffer from tennis elbow either from an injury to the outer elbow or from overuse of the arm and wrist. Some people have elbow pain as a result of arthritis (osteoarthritis). Arthritis is a different condition to tennis elbow but may make it more likely you suffer from tennis elbow. Tennis elbow is painful and often the tissues around the outer elbow become tender to touch and inflexible. The problem is mainly located at the bony part at the outer edge of your arm – called the lateral epicondyle. However it can also refer pain further up or down your arm. Tennis elbow is not the same as golfers elbow (medial epicondylitis.) Both have similar symptoms but golfers elbow is on the medial elbow and tennis elbow is on the outer elbow. 

Tennis elbow is caused by an injury to the tendons and muscles of the outer elbow and forearm. This could be caused by a sudden or awkward movement of the elbow - for example, a backhand in tennis or another racket sport. It could be caused by a direct trauma or blow to the outer elbow. Another cause is overuse and repetitive movement of the lateral elbow such as in gripping tasks for example overuse of a computer mouse or keyboard, painting, hammering, to name a few. 

Both injuries and repetitive strain lead to damage of the tissues of the elbow especially:

Tendon problems
The primary cause of tennis elbow is tendon strain. Tendons connect muscles to bone and enable our body to move. In the outer arm a number of tendons attach to the lateral epicondyle. An acute injury of the elbow can lead to overstretching of the tendons of the outer arm. As a consequence there can be inflammation around the tendon called tendonitis. Overuse and repetitive movements of the outer arm such can lead to micro-tears in the tendon when it attaches to the outer elbow, this is a separate condition called tendinosis.

Above: A diagram of the elbow joint, the arrow points to the tendons of the outer elbow which are affected in tennis elbow. 

Muscle strain
A secondary symptom of tennis elbow is pain in the forearm. This is because tendons are connected to muscles and as a result with tendon strain there can also be problems with the associated muscles. Usually it is due muscle spasm especially in these muscles. 

Bursitis
Bursas are fluid-filled sacs which cushion and reduce friction between tendons/muscles and the bones of a joint. Bursitis is a condition when these sacs become inflamed. The tip of the elbow has a bursa called the olecranon bursa and this can sometimes be affected with tennis elbow.

Ointments/creams
Topical creams and oils can help to stimulate the tissues around the elbow and alleviate tennis elbow pain. Have a chat to your local health store or chemist for more information.

Use compressions
Apply cold compression within 36 hours of an injury to the elbow. After this apply warm compression, this will help to encourage bloodflow and stop pain.  Wearing a compression bandage for periods during the day can also be helpful as this helps to stop swelling and also improves bloodflow.

Elevation
Having your elbow above the level of you heart when your are able to is another way of reducing swelling around your tennis elbow injury.

Rest/Exercise
To assist with recovery it is important to have a mixture of both rest and gentle movement of your elbow. Sometimes it can be helpful to use a forearm splint to reduce symptoms.

Acupuncture
Acupuncture is an effective treatment for people suffering from tennis elbow. Not only does it provide side effect free pain relief, it also is helpful in the repair and rehabilitation of tennis elbow. This is due to the fact that acupuncture has a natural anti-inflammatory effect. Also acupuncture helps to boost the body’s natural immune response to encourage healing of the tendons of the outer elbow. Acupuncture is ACC approved and is an important modality in the treatment of tennis elbow for ACC. Find out more information and book a consultation here.

Physiotherapy
Physiotherapists treat a large number of different injuries and musculoskeletal conditions including tennis elbow. The aim of physiotherapy is to rehabilitate injuries and assist in increasing the functional ability of people suffering from disabilities. In the case of tennis elbow, physiotherapists use a number of different treatment methods including massage and exercises to help rehabilitate tennis elbow.

Other
Osteopaths and Chiropractors who specialise in the extremities (arms and legs) can also help with recovery from tennis elbow 

There are a number of different exercises for tennis elbow. The following exercises can be helpful for tennis elbow but ask your health professional if they are right for you.