Tennis Elbow- Diagnosis and Management

Diagnosis

1. Tender lateral epicondyle

2. Pain with passive wrist flexion 

3. Pain with resisted wrist extension  

Management- Rest, Ice pack, NSAIDs

1. Activity Modification- Avoid activities that exacerbates symptoms

2. Counter Force Brace- Placed on forearm 6-10 cm distal to elbow joint

3. Physical Therapy 

a. Wringing Exercise- Roll up the hand towel. With arms extended, grasp towel with the wrist of    affected side placed in slight flexion. Exert maximum wring pressure- first fully flexing wrist for 10 seconds, then fully extending the wrist for 10 seconds. Alternate flexion extension between hands. 

Perform twice a day, 10 seconds in each direction, increasing 5 secs each week till 60 seconds.

 b.  Weights Exercise- Using handheld weights or dumbells, muscles are strengthened. Start with 0.5 kg, increase gradually to 5 kg depending upon the patient. Flexion extension repeated 10 times, done twice with 1 minute rest in between

         
c. Glucocorticoid injection- Effective but high rate of recurrence. Maximum 2 times is recommended.

If not getting better or getting worse, orthopedics referral.