Tennis elbow, also known as lateral epicondylitis, is a common condition characterized by pain on the outer side of the elbow. While primarily associated with localized pain, it can also lead to numbness in the fingers. This article explores the relationship between tennis elbow and finger numbness, other common causes of arm and hand numbness, and when to seek medical advice.
Understanding Tennis Elbow
Tennis elbow is an overuse injury affecting the tendons on the outside of the elbow. This condition involves the extensor carpi radialis brevis (ECRB) tendon, which connects forearm muscles to the humerus bone at the elbow. Repetitive motions of the arm and wrist, such as those involved in sports like tennis or certain occupational activities, can strain these tendons, leading to inflammation or microscopic tears.
The primary symptoms of tennis elbow include pain and tenderness on the outer part of the elbow. This discomfort worsens with activities like gripping objects, lifting, or extending the wrist and fingers. A weakened grip can also be a noticeable symptom.
The Link to Numbness: How Tennis Elbow Can Affect Nerves
While tennis elbow itself primarily causes pain due to tendon irritation, the inflammation and swelling around the elbow can, in some instances, indirectly affect nearby nerves. The radial nerve, which runs along the back of the upper arm and forearm, passes close to the elbow’s outer side. Its deep branch, known as the posterior interosseous nerve (PIN), is susceptible to compression or irritation in this area.
When the radial nerve or PIN is affected, individuals may experience symptoms beyond typical elbow pain. These can include numbness, tingling, or weakness in the forearm, extending to the back of the hand, thumb, and the first two fingers. This nerve involvement is a secondary complication, rather than a direct symptom of the tendon injury itself. Conditions like radial tunnel syndrome, which involves compression of the radial nerve or PIN, can mimic or even coexist with tennis elbow, making accurate diagnosis important. The sensory disturbances from nerve irritation in this region are subtle or intermittent.
Other Causes of Finger Numbness in the Arm
Finger numbness is a symptom that can arise from various conditions affecting the nerves in the arm and hand, not just those indirectly related to tennis elbow. Other nerve entrapment syndromes are responsible for these sensations.
One common cause is carpal tunnel syndrome, which results from pressure on the median nerve as it passes through a narrow passageway in the wrist. Symptoms include numbness and tingling in the thumb, index finger, middle finger, and half of the ring finger. These sensations worsen at night or with repetitive hand movements.
Another common condition is cubital tunnel syndrome, involving compression of the ulnar nerve on the inside of the elbow. This leads to numbness and tingling in the little finger and the other half of the ring finger. Pain on the inner side of the elbow and a weakened grip can also occur, with symptoms exacerbated when the elbow is bent for prolonged periods.
Less commonly, other forms of radial nerve entrapment in the forearm can also cause sensory changes. This might manifest as numbness over the back of the hand, thumb, and index finger. These conditions present with pain in the forearm and can be mistaken for tennis elbow due to overlapping pain locations.
When to Consult a Healthcare Professional
It is advisable to seek medical attention if you experience persistent or worsening numbness or tingling in your arm or fingers. This is particularly true if the sensations do not resolve with rest or if they begin to interfere with your daily activities.
Significant weakness in the hand or fingers, difficulty gripping objects, or dropping things also warrant a professional evaluation. A sudden onset of severe numbness, especially if accompanied by other symptoms like chest pain, confusion, or slurred speech, requires immediate emergency medical care. It is important to avoid self-diagnosing these symptoms, as proper medical assessment is important for an accurate understanding of the underlying cause.
Diagnosis and Management of Arm and Hand Numbness
Diagnosing the cause of arm and hand numbness begins with a thorough medical history and physical examination by a healthcare professional. During this assessment, the doctor will inquire about the nature of the symptoms, their duration, and any aggravating or relieving factors. Physical tests may involve assessing sensation, muscle strength, and specific movements to pinpoint the affected nerve.
To confirm a diagnosis or to rule out other conditions, specialized tests may be utilized. Nerve conduction studies and electromyography (NCS/EMG) are common tools used to measure how well electrical signals travel along nerves and to assess muscle function, helping to identify nerve compression or damage. Imaging tests like X-rays or magnetic resonance imaging (MRI) might also be ordered to visualize bone structures or soft tissues that could be compressing a nerve.
Management approaches for arm and hand numbness start with conservative treatments. These can include rest, modifying activities that worsen symptoms, and taking anti-inflammatory medications to reduce swelling and pain. Physical therapy, incorporating specific exercises and nerve gliding techniques, is recommended to improve nerve mobility and strengthen surrounding muscles.
Bracing or splinting can also help by immobilizing the affected joint and alleviating pressure on the nerve. In some cases, steroid injections may be administered to reduce localized inflammation. If conservative measures do not provide sufficient relief or if nerve compression is severe, surgical intervention may be considered to decompress the affected nerve.