Tennis Elbow: Causes, Symptoms, and Treatment Options in North Georgia
Elbow Anatomy
The elbow joint is made up of three bones: the humerus (upper arm bone) and the radius and ulna (the two forearm bones). At the lower end of the humerus are bony bumps called epicondyles, which serve as important attachment sites for tendons and muscles. The bump on the outside of the elbow is the lateral epicondyle, where the tendons that extend the wrist and fingers attach. These tendons and forearm muscles are essential for gripping, lifting, and stabilizing the wrist.
When these tendons develop tiny tears from repeated motions, pain and inflammation occur at the outer part of the elbow. This condition is known as tennis elbow, or lateral epicondylitis.
What is Tennis Elbow?
Tennis elbow is a painful overuse injury that affects the tendons on the outside of the elbow. Also known as lateral epicondylitis, it develops when repeated motions of the wrist and forearm strain the tendon attachment at the lateral epicondyle. Over time, the repeated stress leads to microtears, tendon degeneration, and inflammation.
Despite its name, most people who develop tennis elbow never play tennis. It is one of the most common injuries seen by orthopedic surgeons and sports medicine specialists because it affects athletes, workers, and hobbyists alike.
Tennis elbow is closely related to golfer’s elbow, or medial epicondylitis, which occurs on the inside of the elbow. Both conditions involve tendon inflammation, but tennis elbow affects the outside of the joint.
Risk Factors and Causes of Tennis Elbow
The most common cause of tennis elbow is repetitive use of the forearm muscles, but several risk factors can make you more likely to develop tennis elbow:
- Playing tennis or other racket sports with poor technique, especially repetitive backhand strokes
- Repeated motions in daily life, such as typing, painting, hammering, raking, or gardening
- Work-related activities requiring gripping or lifting, such as carpentry, plumbing, or computer work
- Direct trauma to the injured elbow from a fall or accident
- Advancing age, since tendons naturally lose flexibility and strength
In all of these situations, the same motions are repeated over and over, leading to injury of the tendon and eventually constant pain.
Symptoms of Tennis Elbow
The main symptom of tennis elbow is pain on the outer part of the elbow. Symptoms of tennis elbow often develop gradually and may worsen over several months. Common signs include:
- Elbow pain that radiates into the forearm and wrist
- Weak grip strength, making it difficult to hold objects
- Pain when shaking hands, lifting a coffee cup, or gripping a steering wheel
- Tenderness to touch over the lateral epicondyle
- Pain that worsens when the wrist is bent back or when the hand is straightened against resistance
- Difficulty performing daily tasks due to arm pain and reduced strength
For most people, the dominant arm is affected, though tennis elbow can occur in either arm.
Diagnosis of Tennis Elbow
Diagnosing tennis elbow usually involves a thorough review of your medical history, a physical examination, and sometimes imaging studies. During the exam, your doctor will evaluate tenderness, grip strength, and reproduction of pain with wrist or finger extension.
To rule out other causes of elbow pain, your orthopedic specialist may order:
- X-rays to assess the elbow joint and rule out bone problems
- MRI scans to evaluate tendon health and detect tiny tears
- Electromyogram (EMG) or nerve conduction studies if nerve compression is suspected
This comprehensive evaluation helps confirm the diagnosis and ensures the right treatment plan is recommended.
Nonsurgical Treatment Options for Tennis Elbow
Most people with tennis elbow improve without surgery. Nonsurgical treatment options are designed to reduce pain, promote tendon healing, and restore function. These may include:
- Rest and activity modification: Avoiding repeated motions that strain the tendon is often the first step to reduce pain.
- Ice and anti-inflammatory medications: Applying ice packs and taking pain relievers or anti-inflammatory medications can decrease swelling and tenderness.
- Bracing and splinting: Using a counterforce brace or wrist splint decreases tension on the injured tendon.
- Physical therapy: Once pain decreases, exercises for stretching and strengthening the forearm muscles are started. Therapy may also include manual therapy, massage, and progressive loading exercises to build tendon resilience.
- Extracorporeal shock wave therapy (ESWT): This treatment uses sound waves to stimulate healing, improve blood flow, and reduce pain in the affected area.
- Platelet-rich plasma (PRP) injections: Concentrated platelets from your own blood are injected into the injured tendon to promote repair.
- Ultrasound therapy: Pulsed ultrasound may help increase blood flow and healing in the injured tendon.
Nonsurgical treatment options are successful for most people, though recovery may take several months of consistent care.
When to Consider Tennis Elbow Surgery
If nonsurgical treatments fail and symptoms persist for 6–12 months, your doctor may recommend tennis elbow surgery. Surgery is often considered when there is constant pain, loss of function, or a lack of improvement despite physical therapy and other conservative measures.
Tennis Elbow Surgery: The Procedure
Tennis elbow surgery, also known as lateral epicondyle release surgery, is designed to fix tennis elbow by removing damaged tendon tissue and reattaching the healthy portion to bone. There are two main surgical approaches:
- Open surgery: A single incision is made to access the tendon directly.
- Minimally invasive surgery: Small incisions and an endoscope (a lighted tube with a camera) are used to repair the tendon with less soft tissue disruption.
During surgery, the surgeon carefully trims the injured tendon, removes scar tissue and bone spurs, and secures the tendon back to the lateral epicondyle.
Recovery After Tennis Elbow Surgery
Most people return home the same day after surgery. A splint or brace may be used briefly to protect the elbow. Physical therapy begins soon after to restore range of motion and gradually strengthen the forearm muscles.
Recovery is a gradual process, and most people return to daily activities within several weeks. Full recovery may take several months, but surgery has a high success rate in relieving pain and improving grip strength.
Everyday Life After Treatment
Once healed, most people return to work, sports, and hobbies without limitation. To prevent recurrence:
- Warm up before physical activity
- Use proper technique when you play tennis or other sports
- Strengthen forearm and shoulder muscles with exercises
- Take breaks when doing repetitive tasks
- Avoid overuse of the injured tendon
With the right treatment and prevention strategies, tennis elbow can be effectively managed so you can return to an active lifestyle.
Why Choose Dr. Thomas Neustein for Tennis Elbow Care in North Georgia
Dr. Thomas Neustein is a board-certified orthopedic hand and upper extremity surgeon who specializes in diagnosing and treating conditions like tennis elbow, golfer’s elbow, and other common sports and work injuries. He offers the full spectrum of care — from nonsurgical treatments such as physical therapy, ESWT, and PRP injections to advanced surgical procedures when needed.
Patients in Duluth, Dawsonville, and Braselton benefit from Dr. Neustein’s expertise and personalized treatment plans designed to reduce pain, restore strength, and get you back to the activities you enjoy.
Schedule an Appointment
If you are struggling with tennis elbow or ongoing elbow pain, don’t wait until it becomes a constant pain that limits your daily life. Schedule an appointment with Dr. Neustein today to discuss your treatment options and start your path to recovery.
