Tennis elbow: associated psychological factors

https://doi.org/10.1016/j.jse.2017.11.033Get rights and content

Background

The etiology of tennis elbow is multifactorial. Overuse of the wrist extensors along with anatomic factors, such as flexibility problems, aging, and poor blood circulation, may play a role. This study investigated whether patients with tennis elbow have a different psychological profile compared with healthy controls.

Methods

Patients with clinical signs of tennis elbow, consulting at the Ghent University Hospital between September 2015 and January 2017, were offered a paper-and-pencil questionnaire about Big Five personality traits, perfectionism, anxiety, depression, work satisfaction, and working conditions. Healthy controls in the same risk group were offered the same questionnaires.

Results

We recruited 69 patients (35 men, 34 women) and 100 controls (44 men, 56 women). Tennis elbow patients scored significantly lower on the personality traits extraversion and agreeableness. Men, in particular, scored significantly higher on perfectionism and were more likely to develop an anxiety disorder or a depression. Concerning work, patients indicated a significantly higher workload (especially men) and a significantly lower autonomy (especially women). Female patients also indicated less contact with colleagues. However, work satisfaction was relatively high in both groups.

Conclusion

The results suggest that there is a relationship between complaints related to tennis elbow and psychological characteristics.

Section snippets

Study design

The study design was a prospective case-control study.

Patients

The study sample consisted of patients with clinical signs of tennis elbow consulting at the Ghent University Hospital between September 2015 and January 2017. The diagnosis of tennis elbow was made on clinical grounds: pain at the lateral epicondyle or just distally of it for at least 6 weeks and a painful resisted dorsiflexion of the wrist (more painful with the elbow in extension than with the elbow in flexion). Exclusion criteria were

Results

Table III reports the mean scores of the total patient population on the different aspects of the questionnaire compared with the mean scores of the healthy controls. Table IV reports the mean scores of the male and the female patients separately, compared with, respectively, the healthy male and the healthy female controls.

Discussion

To our knowledge, the present study is the first to simultaneously examine personality traits, anxiety, depressive feelings, and working conditions in tennis elbow patients to find out which psychological factors play a role in the etiology of tennis elbow.

The analyses revealed a significant difference between tennis elbow patients and controls for the dimension agreeableness. Tennis elbow patients scored significantly lower on this dimension than controls. Such characteristics could complicate

Conclusions

The main conclusion is that tennis elbow patients are less agreeable and have more depressive feelings and that male tennis elbow patients (but not female patients) are more positive perfectionists compared with healthy controls. Furthermore, differences between tennis elbow patients and controls on working conditions are gendered to some extent.

Although the results are not strong enough to define a specific tennis elbow personality, some recommendations can be made. Doctors and therapists

Disclaimer

The authors, their immediate families, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

References (19)

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The University Hospital Ghent Ethical Committee approved this study (Study number: B670201524800).

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