Workers with tennis elbow have a sporting chance of recovering completely within two to six months, although in some cases the condition may persist for longer. This fact sheet will help you understand this common condition, so that you can assist affected workers back to suitable work as soon as possible.

What is tennis elbow?

Tennis elbow involves soreness and tenderness in the outer part of the elbow, which may extend to the muscles in the top of the forearm.  Movements of the wrist may increase the pain, as may gripping, for example turning a key or shaking someone’s hand. Usually, the onset of symptoms is gradual but the pain may become constant.

The medical term for tennis elbow is ‘lateral epicondyle’. Tennis elbow develops when the tendon that joins the muscles of the forearm to the upper arm bone (the humerus) tears or becomes inflamed. 

What causes tennis elbow?

‘Tennis elbow’ sounds like a sporting injury, but the problem can develop in many contexts and may not have a single cause.

Risk factors include:

• Smoking;
• Obesity;
• Repetitive movements of the arm;
• Forceful use of the arm; and
• Holding the hand and arm in awkward positions.

In rare instances, tennis elbow may occur following a single incident. The culprit might be heavy lifting, or engaging in physical activity that is out of the ordinary for the person affected.

Tennis elbow most commonly occurs in people aged 30 to 50 and is relatively common amongst working-aged individuals.

How might work contribute to the development of tennis elbow?

There are many work factors that increase a person’s risk of tennis elbow. Studies have shown that the following work factors are associated with the onset of tennis elbow:

• Repetitive movements for more than two hours a day;
• The use of heavy, hand held tools;
• High physical strain, such as :
  • Non-neutral posture of hands and arms;
  • Forceful work; and
  • Repetition;
• Handling heavy loads at least ten times a day;
• Low job control; and
• Low social support—especially for female workers.

What are the most effective ways of dealing with tennis elbow?

There are many simple strategies for dealing with tennis elbow that the affected person—and their supervisor or manager—can put into place. In high risk workplaces it may be appropriate to educate supervisors and workers about these strategies as a matter of course.

“Self-help” remedies include:

• Resting the affected arm, in order to allow the tendon to heal;
• Applying a cold compress to reduce pain, especially if there has been a sudden flare-up;
• Wearing strapping or a splint during active hours, to help restrict the movement of the tendon and relieve strain;
• Taking anti-inflammatory medicine, such as ibuprofen; and
• Learning how to perform tasks in ways that place less strain on the tendon.

In order to get on top of the problem quickly, it is also a good idea to visit a GP and ask for advice.

The GP may recommend:

• Physiotherapy, including strengthening exercises;
• Prescription pain killers; or, if the pain has not resolved after some months
• Steroid injections.

Surgery is a possible treatment for tennis elbow, but it is rarely required and only used as a last resort.

How can tennis elbow be prevented?

Again, there are very simple measures that can be taken to prevent tennis elbow developing in the first place. High-risk workplaces should inform workers and supervisors about preventative measures and allow workers the time to put them into practice.

The risk of developing tennis elbow may be reduced by:

• Warming up before forceful activities with five minutes of gentle exercises;
• Taking regular breaks from repetitive tasks, which may include alternating tasks where appropriate;
• Reporting pain early, and seeking the appropriate medical support; and
• Ergonomics education and adjustments in the workplace.

References:
Am J Epidemiol. 2006 Dec 1;164(11):1065-74. "Prevalence and determinants of lateral and medial epicondylitis: a population study." Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M.
Occup Environ Med 2003;60:322-329 doi:10.1136/oem.60.5.322 "Physical and psychosocial risk factors for lateral epicondylitis: a population based case-referent study" J P Haahr, J H Andersen van Rijn RM, Huisstede BM, Koes BW, Burdorf A. Rheumatology (Oxford). May 2009;48(5):528-36. "Associations between work-related factors and specific disorders at the elbow: a systematic literature review."
http://hcd2.bupa.co.uk/fact_sheets/html/tennis_elbow.html