You may not play Tennis, but you could have a Tennis elbow

You may well be puzzled. Your rheumatologist has told you that you've got a ' tennis elbow ', yet, you might never have held a tennis racquet in your life ! The truth is the ailment is caused by a physical strain. Of course, a strenuous game of tennis could be the cause, but it could be any one of a number of activities. People whose professions call for gripping and twisting - carpenters and dentists, for instance - are particularly prone to this painful condition.

The medical name for tennis elbow is 'lateral epicondylitis'. The lateral epicondyle is the bony part you can feel on the outside of your elbow joint. It is outside the joint and so is unaffected by arthritis or deformity, but it is often prominent, especially in thinner people, and consequently it can easily be knocked, which causes soreness and bruising.

Tennis elbow usually occurs in those between 40 to 60 years of age. Different people experience varying degrees of pain ranging from a mild discomfort when the arm is used, to an ache severe enough to disturb their sleep. The pain gets worse by gripping or twisting movements and the lateral epicondyle will feel tender- something you will notice, particularly if you touch your elbow.

Repeated movements of the wrist, especially those meeting resistance - such as a backhand tennis stroke - will make matters worse. The same might happen if you use a paint roller on a ceiling. This is because those tendons that enable you to stretch your fingers and wrists backwards (known as the extensor tendons) all come together and are fixed into the lateral epicondyle. Lifting heavy weights at work or at home can cause further aggravation.You may also feel pain further down your forearm.

However, if you experience a sensation of tingling in the arm or fingers, that would indicate some other condition, such as pressure on the nerve in the neck (cervical spondylosis), or at the wrist (carpal tunnel syndrome). Occasionally, there maybe a little swelling around the localised tender areas of the elbow joint. You may then be asked to take some X - rays or blood tests but it is nothing to worry about as it is not a serious form of rheumatism.

Tennis elbow usually arises when the tendons coming from the muscle of the forearm become inflamed at the point where they join the epicondyle. Although it is painful, it is quite harmless; there are no long - term effects and it has nothing to do with arthritis or any other disease.

The condition is likely to get better if you leave it alone and cut down excessive or repetitive movement of the elbow. Sometimes, putting your arm in a sling for a few days will do the trick. Some people find warmth (from a hot water bottle, for example) helps. Others find that a cold ice - pack (such as a packet of frozen peas wrapped in a towel) - placed on the tender area twice a day for ten minutes - is beneficial. Mild pain-killing tablets prescribed by your rheumatologist will also help.

If the pain shows no sign of abating, your rheumatologist may suggest a cortisone drug (steroid) injection into the tender area. There is no risk of side-effects since the drug is injected only into the affected area (some people suffer when steroids are taken by mouth).

There is a slight possibility that the pain may actually become worse for a few hours after the injection. The severe pain may last for about 48 hours. A repeat injection may be necessary if the pain persists. However, 75 percent of patients recover after the first injection, though you may still be advised to rest your elbow as much as possible for up to two or three weeks afterwards.

If the pain coninues and becomes 'chronic' (lingering), physiotherapy might help. Deep massage and friction combined with ultrasound may be suggested. The ultrasound penetrates deep into the painful tissues and eases the discomfort. Occasionally for long-standing cases, manipulation is advised to break down any fibrous adhesions that may have formed.

Various methods of strapping or splinting the forearm may be tried to relieve the strain on it. In very rare cases the elbow has to be encased in plaster to rest the area completely and allow the inflammation to settle. Equally rarely, an orthopaedic surgeon might be asked to relieve the condition by a minor tendon - releasing operation.

If you're suffering from tennis elbow you will have to face the fact that you may have pain for some time - perhaps as long as a year or even more. But the good news is that the condition is what's known as 'self - limiting'; meaning it will get better naturally.