Tennis Elbow Treatment

Dr. James - Orthopaedic Surgeon in Singapore

Medically reviewed by Dr. James Tan

Contents

    What Is Tennis Elbow?

    Tennis Elbow, or lateral epicondylitis, is a type of overuse injury caused by the repeated motion of the arms and wrists. Mostly, tennis players who consistently grip their racquets too tightly experience this condition. However, it is not exclusive to tennis players and can affect anyone who makes repetitive movements with their arms and hands. It is caused by the overuse of the muscles and tendons in the outer elbow.

    Read along further to find out about tennis elbow symptoms, its causes and diagnosis, and various tennis elbow treatment options in Singapore.

    tennis elbow illustration
    Image Credit: News Medical

    How Does Tennis Elbow Feel?

    Tennis elbow manifests itself as pain on the outside of the elbow. Tennis elbow pain may even extend down into your forearm and hand depending on the severity of the injury. In mild cases, you might feel discomfort or pain while making certain movements with your arm or hand. In more severe cases, you might feel pain even when the arm is at rest.

    What Causes Tennis Elbow?

    In our arm, there are tissues called tendons which connect the forearm muscles to the bony bump in the elbow. When these tendons become overwhelmed due to repeated movements, overuse, or muscle strains, they get inflamed. The tendon fibres can break down, degrade, or even tear.

    With repetitive use of forearm muscles, the tendons and muscles become sore from the excessive strains, which may cause tennis elbow lateral epicondylitis. Sometimes, knocking and banging your elbow against a hard surface can also result in a Tennis Elbow. The continuous strain on the tendons can result in increased inflammation and pain, a condition called tendonitis. If left untreated, the tendons can start to degenerate causing the degenerative disease tendinosis. 

    Some of the common Tennis Elbow causes include: 

    • Using a too-short or tight tennis racket 
    • Poor backhand stroke 
    • Weak wrist muscles and shoulder 
    • Overusing the computer mouse and other plumbing tools 
    • Painting
    • Driving Screws

    Sometimes, an injury or disease of the connective tissues in your body may cause tennis elbow. However, in many cases, the cause of tennis elbow is unknown. 

    While most pain is caused by overuse or excessive strain in the forearm or elbow, it can also be caused by an injury to your arm. 

    Common Symptoms of Tennis Elbow

    Since this condition can be caused by overuse of the arm and wrists or through overexertion in sports, the symptoms may usually come on slowly. You may find that that pain gets worse gradually over a period of time.

    A few telltale signs include:

    • Pain in your outer elbow and forearm
    • Discomfort that extends to your wrist
    • Aches that get worse at night
    • Pangs when you twist or bend your arm
    • Pain when trying to lift and pick up small objects
    • Stiffness when you extend your arm
    • Pain when you place your arms on a table with palms down and then raise them
    • Swollen elbow joint
    • Outer elbow and forearm tender to the touch
    • A weak grip

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    What's The Difference?

    Olecranon Bursitis VS Tennis Elbow

    Although both cause pain to your elbow joint due to overuse, Olecranon Bursitis and Tennis Elbow are two different conditions.

    Olecranon Bursitis

    Inflammation in the Bursa around your elbow.

    May present as pain, redness, discolouration, or tenderness at the elbow. Pain may be present even at rest.

    Tennis Elbow

    Extensor tendons in the elbow become inflamed or torn (including micro tears).

    May present as pain in the outer elbow and forearm that may extend towards the wrist. Pain usually manifests with arm movements.

    Where To Find Tennis Elbow Treatment in Singapore

    Tennis elbow is one the most common causes of elbow pain, and it affects more than just tennis players. Known by doctors as lateral epicondylitis, this painful condition is caused by repetitive motions that weaken your muscles and can cause tears to the tendons in the outer elbow. 

    If you’ve been dealing with nagging pain from tennis elbow, consider seeking treatment. The orthopaedic doctor here at Ray of Health will diagnose your issue and create a customised orthopaedic treatment plan to help you manage your condition. We also treat other sports injuries like meniscus tears and rotator cuff injuries.

    Why suffer in pain for another day? Reach us online, call +65 6235 8781, or chat with us on WhatsApp at +65 8028 4572. You can also talk to us by clicking the button below.

    Locations

    Camden Medical

    1 Orchard Boulevard, #09-06

    Singapore 248649

    Mount Alvernia Hospital

    820 Thomson Road

    Medical Centre D #05-60

    Singapore 574623

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    Treatment Process With Our Tennis Elbow Specialist

    Dr James Tan, our tennis elbow specialist at Ray of Health, deals with various orthopaedic conditions of the body. He advises his patients to consult him in case of any pain or injury at the earliest so that the condition can be assessed and diagnosed properly.

    1. Registration: First, register with Dr James' team and book an appointment here.
    2. First appointment: At the first appointment, Dr James Tan will carry out a thorough physical exam for your tennis elbow, and evaluate your medical history.
    3. Diagnosis: Typically, additional diagnostic tests are required to assess the causes of the problems accurately. This usually comes in the form of MRI or X-ray scans.
    4. Personalised Treatment Plan: Dr James will then create a personalised treatment plan based on your specific condition and needs, which could include undergoing surgery, and recommend the necessary treatment modalities to you.
    5. Follow-up sessions: Dr James will schedule additional follow-up sessions to monitor the recovery process until you fully recover.

    Disclaimer: Treatment plans may differ for different patients. Please contact Dr James for more information.

    dr james tan

    Accreditations

    1. Mount Elizabeth Orchard
    2. Mount Elizabeth Novena
    3. Farrer Park Hospital
    4. Mount Alvernia Hospital
    5. Aptus Surgery Centre
    6. Novaptus Surgery Centre

    Medisave & Insurance Shield Plan Approved

    If you are a Singaporean or a Permanent Resident of Singapore, some of our orthopaedic procedures can be claimed under Medisave. The claimable amount will vary based on the procedure's complexity.

    For other situations, please consult our friendly clinic staff regarding the use of your Integrated Shield Plan insurance.

    Personal Insurance

    1. Great Eastern
    2. Prudential
    3. HSBC Life

    Corporate Insurance

    1. MHC
    2. Fullerton
    3. Adept
    4. Alliance
    5. IHP
    6. iXchange
    7. Parkway Shenton
    8. Bupa
    9. Cigna

    How Do Doctors Check for Signs of Tennis Elbow?

    When you come to our Singapore clinic, Dr James Tan will start with a physical examination in which he will examine your arm and elbow, and check for your symptoms while moving the arm in various positions. He will check for any swelling and pain while applying gentle pressure to the elbow. He will also check for any occupational risk factors and your sports participation. You should inform the doctor if you have any conditions like rheumatoid arthritis or nerve disease, or if you have ever injured your elbow. 

    Moreover, Dr Tan may also carry out the tennis elbow test called Mill's Test to diagnose the condition.

    He may also recommend one of the following imaging exams. 

    • X-rays: X-rays can be used to rule out other bone-related conditions like arthritis or a fracture.
    • MRI or CT: Magnetic resonance imaging (MRI) or computed tomography (CT) scans are used to take a clearer look at the damage to your tendons and muscles. They can help determine the extent of damage to the tendons or rule out other conditions like a herniated disc or arthritis.
    • EMG: An electromyography (EMG) test can measure your nerve's electrical activity and may be used to rule out nerve compression at the elbow since it can also cause similar symptoms.

    How To Treat Tennis Elbow?

    A majority of patients experience relief from non-surgical treatment options. Let’s look at a few of the most common tennis elbow treatment Singapore options that your doctor may recommend.

    • Rest: This is usually the most common treatment modality that doctors advise. Giving your arm adequate rest from activities so that your tendons may heal is very important.
    • Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs, like ibuprofen, aspirin, and naproxen may help reduce pain and inflammation.
    • Tennis elbow brace: Wearing a removable support brace or an elbow guard for tennis elbow can help take the stress off of your tendons and muscles while they heal.
    • Physical therapy: Strategic exercises can help build up the muscles of your forearm and improve your grip strength.
    • Massage: Focused massage can help reduce pain while improving your range of motion.
    • Steroid injections: For more severe cases, corticosteroids may be recommended to relieve pain and inflammation in the elbow and arm.
    • Platelet-rich plasma (PRP) injections: PRP involves taking the platelets from the patient's blood and injecting them into the elbow to create an improved biological environment for the tendons to heal.
    • Shockwave therapy: In this therapy, sound waves are sent to the elbow which, in turn, promotes the body's natural healing process.

    If your symptoms do not improve or worsen after 6 to 12 months of conservative treatment, your doctor may recommend surgery and refer you to a surgeon. The surgical treatment for tennis elbow usually involves removing the damaged tendon from the elbow and replacing it with a healthy tendon. The surgery can be carried out either as an open surgery or through arthroscopy.

    • Open Surgery: In this approach, the surgeon makes an incision on the outside part of the elbow and the damaged tendon is replaced with a healthy tendon and attached to the elbow bone.
    • Arthroscopic Surgery: In arthroscopic surgery, very small incisions are made on the outer elbow and thin surgical instruments and a camera is inserted through the incisions. The camera guides the surgeon in carrying out the surgery.

    Following the surgery, you may have to wear a splint or tennis elbow strap to keep the arm immobilised for a week or so. Once the splint and sutures are removed, you will be required to engage in physical therapy. Rehabilitation post-surgery will involve light tennis elbow exercises followed by strengthening exercises. Tennis elbow surgery has a good success rate of 80% to 90%. However, it does carry the risk of patients experiencing a loss of strength.

    Treating Tennis Elbow at Home

    We often get questions about how to treat tennis elbow pain at home. While it is essential to remember that you need to get examined by a professional, some natural cures can help with mild cases.

    You may consider doing light exercises for tennis elbow at home to reduce swelling and improve mobility. But always consult your doctor or physiotherapist before starting any exercise regimen.  

    Resting your arm and wrist is important to allow the tendons to heal. Using hot or cold therapy may also be beneficial for managing pain and inflammation.

    Is Hot or Cold Better For Tennis Elbow?

    During the early stages of an injury, it is better to opt for cold treatment as it can help reduce inflammation. Applying ice on the affected elbow for 15 minutes, a few times a day can help with inflammation and pain. However, after the initial inflammation has subsided, you may switch to heat therapy. Applying heat to the affected elbow and surrounding areas can help relax the muscles and increase blood circulation, allowing the injured tendon to heal.

    Is Deep Heat Good For Tennis Elbow?

    Deep Heat Rub can work in a similar way to that of applying a hot compress. If you’re dealing with long-term pain, this can be a good solution. However, always consult your doctor before using any topical or oral medications or rubs.

    Is Tiger Balm Good For Tennis Elbow?

    Like Deep Heat, products like Tiger Balm can help warm the area and provide pain relief to some extent. This can be a good option for occasional use but it is important not to overuse it. If the pain persists, consider consulting an elbow specialist for proper diagnosis and treatment.

    Exercises To Help Manage Tennis Elbow Pain

    Check out this video below for effective stretching exercises that can help relieve tennis elbow pain.

    Frequently-Asked Questions About Tennis Elbow in Singapore

    In tennis elbow, your lateral tendon, the outside part of your elbow, is affected. In contrast, the golfer’s elbow affects the inside part of the elbow comprising the epicondyle tendon.  

    If you have a golfer’s elbow, you will feel a pain on the inner side of your elbow that may travel down your arm. It’s common to feel a tingling or numbing sensation in your fingers with a golfer’s elbow. However, with tennis elbow, the pain will be on the outside of the elbow and can worsen when gripping and twisting things. Dr James Tan at Ray of Heath can help you manage these health conditions. 

    Our golfer's elbow doctors at Ray of Health can help you manage and improve your pain. 

    Disclaimer

    The information provided on this page is for educational purposes only and is not intended as a substitute for professional medical advice or treatment. Always consult your healthcare provider or specialist doctor regarding any medical condition that you might be facing and act on the doctor’s recommendations.

    References:

    1. Benjamin K. Buchanan; Matthew Varacallo, "Lateral Epicondylitis (Tennis Elbow)", National Library of Medicine, National Center for Biotechnology Information, 2023, https://www.ncbi.nlm.nih.gov/books/NBK431092/
    2. "Tennis elbow", National Library of Medicine, https://medlineplus.gov/ency/article/000449.htm
    3. "Tennis elbow surgery", National Library of Medicine, https://medlineplus.gov/ency/article/007590.htm

    About The Author

    dr james tan

    Dr James Tan Chung Hui

    Dr James Tan is a skilled orthopaedic surgeon at Quantum Orthopaedics located at Camden Medical and Mount Alvernia Hospital, known for providing specialised medical services. Dr Tan has more than 10 years of experience in sports surgery and exercise medicine in Singapore. Apart from partnering with the industry to introduce various treatment techniques, Dr Tan has treated athletes from the Singapore National Teams and professional footballers from the Singapore Premier League and the Young Lions.

    Dr Tan specialises in treating sports injuries of the knee, shoulder and elbow joints, as well as cartilage and meniscus surgery. He is a member of the elite Asian Shoulder and Elbow Group and a founding member of the Singapore Shoulder and Elbow Surgery Society.

    Medical Education and Affiliations
    MBBS - National University of Singapore (NUS), Faculty of Medicine
    Member of the Royal College of Surgeons of Edinburgh (MRCS)
    MMed - Master of Medicine in Orthopaedic Surgery (NUS)
    Fellow of Royal College of Surgeons (Edinburgh)
    Adjunct Assistant Professor | NUS, LKC
    Senior Consultant Orthopaedic Surgery, Sports and Exercise Medicine
    Head of Department | Orthopaedic Surgery and Sports Medicine Centre
    Awards
    Principal Investigator of Tissue Engineering
    National Medical Research Council grants
    Collaboration with Scientists at NTU, TUM, A*Star, Osteopore & Trendlines Medical Singapore

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