Causes Of Pseudo Tennis Elbow
Radial Nerve Irritation
The radial nerve extends from the neck and laterally down the arm along the radius to the lateral aspect of the hand, and irritation of it is one of the most common causes of lateral elbow/arm pain. It doesn’t always require a traumatic neck injury or disc problem to kick start this nerve…maybe you’re an office worker who just happens to sit poorly? That combined with prolonged wrist extension may very well be the trigger!
a) Neck source: Radial nerve irritation closer to the neck usually produces a lot more widespread symptoms than just elbow pain. The C6 and C7 nerve roots help to form the radial nerve just outside of the cervical spine. And as you can see the area of symptom distribution extends well beyond your elbow (Diagram 2.). So it’s certainly worth considering if you have pain AND altered sensation in these areas.
b) Radial tunnel syndrome: A less common location where the radial nerve can become compressed is where it passes underneath the Supinator muscle, which is one of the muscles that turn your palm up. Repetitive weightlifting (e.g. biceps curl) for instance with the forearm in supination can lead to muscle hypertrophy and gradual compression of the nerve. You may very well have pain in areas below the elbow (as in Diagram 2.) with GRIPPING activities, WRIST EXTENSION in SUPINATION or even FOREARM SUPINATION against resistance. But numbness is NOT a symptom with this type of disorder.
Superior Radio-ulnar Joint Dysfunction
There is a growing awareness of how dysfunction at this pivot joint just below the elbow (Diagram 1.) can often contribute to elbow pain. Again weight-lifters watch out!… as repetitive activities such as weightlifting with the forearm in pronated positions (e.g. cling and press) over a prolonged period of time can lead to overuse and hypertonicity of the pronator teres muscle. As this muscle attaches to the front aspect of the head of the radius, over-activity can displace the head of radius by dragging it forward, leading to inflammation of the joint and pain felt laterally at the elbow. Symptoms are very similar to tennis elbow BUT pain can also be felt with passive ELBOW EXTENSION and FLEXION.