Tennis elbow is a condition where tendon fibres that attach to the epicondyle on the elbow’s exterior degenerate. These tendons anchor the muscles that help the wrist and hand lift. While tennis elbow is most common in individuals aged thirty to fifty, it can affect people of any age, including adolescents. In fact, nearly fifty per cent of teenagers involved in racquet sports experience this condition, hence the name "tennis elbow." Interestingly, most patients with tennis elbow do not play racquet sports. Often, there isn't a specific injury that precedes the onset of symptoms. The condition can also occur in people who frequently and vigorously use their forearm muscles for daily tasks and recreational activities. Some patients develop tennis elbow without any activity-related causes.
Tennis Elbow in Adolescents
The symptoms of tennis elbow include severe burning pain on the exterior of the elbow. Typically, this pain starts mildly and gradually worsens over a few weeks or months. The pain intensifies when lifting objects, even light ones like a book or a coffee cup. In severe cases, any movement of the elbow can cause pain.
Diagnosing tennis elbow involves a physician reviewing the teenager’s medical history and performing a physical examination. This includes pressing on the prominent bone of the elbow to check for pain and asking the patient to lift their fingers or wrist while applying pressure to see if it causes pain. X-rays are not used for diagnosis, but an MRI scan might be done to detect changes in the tendons at the bone attachment.
Various treatment options are available, with non-surgical methods being the first line of approach. The primary goal of initial treatment is pain relief. The physician may advise the teenager to avoid activities that trigger symptoms, apply ice to the elbow, and take anti-inflammatory medications.
Orthotics can also help alleviate symptoms. The physician might recommend counterforce braces or wrist splints to rest the tendons and muscles, usually showing improvement within 4 to 6 weeks. If symptoms persist, a corticosteroid injection near the elbow might be considered to reduce pain, though it should not be overused due to potential side effects.
Once pain relief is achieved, the next phase of treatment focuses on modifying activities to prevent recurrence. Physical therapy, including stretching exercises, is often prescribed to gradually strengthen the affected tendons and muscles. These therapies are highly successful, with non-surgical treatments being effective in eighty-five to ninety per cent of patients.
Surgery is considered only for patients with persistent pain after six months of non-surgical treatment. The procedure involves removing the affected tendon tissue and reattaching it to the bone. This outpatient surgery requires a small incision on the elbow’s exterior. A newer method, arthroscopic surgery, has been developed but offers no significant advantages over the traditional open incision technique.
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