Causes | Tennis elbow

Causes

The main cause of tennis elbow is the overuse of the forearm muscles, which are responsible for stretching the fingers and wrist. Overstrain can be caused by various factors. On the one hand, permanent and constant incorrect strain in everyday life, work (e.g.

screwing, grinding) and leisure time (e.g. sport) can lead to overstrain, as can one-sided strain on the upper body (e.g. when using the mouse/keyboard at work, when climbing, etc.). Incorrect techniques in stroke sports such as tennis or golf can also lead to increased strain on the forearm muscles, as can certain arm positions during sleep (lateral position, lying with the head on the elbow). Painful tendon attachment points on the elbow in the context of other illnesses such as fibromyalgia are to be distinguished. Fibromyalgia is a chronic, incurable disease, in which pain can occur in changing muscles, joints and tendon attachments in relapses.

Diagnosis

In order to be able to make a diagnosis of tennis elbow, the attending physician first begins with an anamnesis, i.e. the collection of a medical history, whereby the emphasis is placed on the characteristic pain symptoms. Subsequently, the elbow is examined, whereby often a pressure pain on the outside, as well as a redness, swelling, overheating or even a relieving posture can be noticed. Often the diagnosis can already be made now, if doubts persist, further clinical tests may follow: firstly the stool test, in which the patient must lift a chair with an extended arm and forearm turned inwards; secondly the Thomson test, in which the hand is closed to the fist and the wrist is bent backwards against resistance (further tests: Bowden test, Mill test, Cozen test).

In addition, blood tests can confirm signs of inflammation (CRP, blood sedimentation rate, leukocyte elevation). Finally, various imaging procedures can be used to resolve uncertainties in the diagnosis: ultrasound examination of the elbow, X-ray of the arm and/or magnetic resonance imaging (MRI) can be applied. As a rule, tennis elbow can be diagnosed solely on the basis of the patient’s medical history, i.e.

the conversation between doctor and patient, and the subsequent physical examination, i.e. the examination of the elbow by the attending doctor.If the results of the examination are not entirely clear, the doctor can use imaging to help. In addition to X-rays and ultrasound, magnetic resonance imaging (MRI elbow) is also used. MRI of the elbow can be used to visualize soft structures particularly well, including the tendons and muscles of the affected elbow. The extent of inflammation can then be determined and possible complications such as muscle/tendon tears can be ruled out.