Tennis elbow, medically named lateral epicondylitis, is an inflammatory condition affecting the outside of the elbow.

The pain of tennis elbow is caused by inflammation of the tendon and periosteum (the outer layer of the bone) where the tendon from the back of the forearm joins the humerus (upper arm bone). The tendon connects the bone to the muscles that straighten the wrist. Any tension on that muscle - for example from a tennis backhand - will cause pain.

Tension on these muscles can be caused by all sorts of activities such as typing, writing, lifting objects with the palm turned down, or using a screwdriver. Even though there is inflammation, there is rarely any swelling. Stiffness and pain in the elbow can usually occur after prolonged periods of rest.

How do you know if you have tennis elbow? Try lifting a book with your palm facing down to the floor. If it causes pain on the outside of the elbow, you probably have tennis elbow.

As you can see, tennis elbow is ultimately caused by overuse of the wrist extensor (straightening) muscles which, by means of the tendons, connect to the elbow. Classically this is caused by the tennis backhand but, as we have seen, can also be caused by other types of repetitive activity.

If this muscle group tightens too much, it will lead to a decrease in joint space in the elbow thereby resulting in an increase in pressure and inflammation in the joint. This results in pain in not only the epicondyle, but the radial-humeral joint as well.

Treatment normally consists of some lifestyle modification, plus anti-inflammatory and muscle relaxant medication. Physiotherapy such as TENS, ultrasound, laser therapy, and interferential current can also prove helpful.

Chiropractic techniques that work well with this condition include soft-tissue therapies such as active release technique, Graston, or cross-fiber friction massage. Chiropractic adjusting of the lateral elbow, including the proximal radial-ulnar joint and the radial-humeral joint, appear to be quite beneficial.

By doing a chiropractic adjustment, pressure is taken of the joint by briefly separarting the joint surfaces by just a couple of millimeters. Easing that pressure eases the pain. Sometimes some manipulation of the wrist can also help.

This is because the muscles that cause the elbow pain operate through the wrist. If the wrist tightens up, more muscular activity is needed to move it, thus causing more tension and more pain. So making sure that wrist motion is maintained should help to ease the whole situation.

Another therapy that can be very helpful is the use of an elbow band. This works by transferring the tendon's tension from its attachment to the bone (where it causes the pain) to the band instead.

Also, though rest would be ideal, there may be times when lifting is needed to be done. In this case, one should only attempt to lift with the palm of the hand turned upward. This uses the wrist flexors more than the wrist extensors.

Two things that have been found to help is to limit salt intake to help reduce water resorption in the body and to supplement with Vitamin B6.

Overall, if you suspect you may have this condition, it is best to have it assessed by your chiropractor and/or medical doctor in order to have the proper treatment plan started that will assist in accelerated recovery.