Tennis Elbow

Tennis elbow is the common name used for the elbow condition called lateral epicondylitis. It is an overuse injury that causes inflammation of the tendons that attach to the bony prominence on the outside of the elbow (lateral epicondyle). It is a painful condition occurring from repeated muscle contractions at the forearm that leads to inflammation and micro tears in the tendons that attach to the lateral epicondyle. The condition is more common in sports activities such as tennis, painting, hammering, typing, gardening and playing musical instruments. Patients with tennis elbow experience elbow pain or burning that gradually worsens and results in a weakened grip.

Your doctor will evaluate tennis elbow by reviewing your medical history, performing a thorough physical examination and ordering X-rays, MRI or electromyogram (EMG) to detect any nerve compression.

Your doctor will first recommend conservative treatment options to treat the tennis elbow symptoms. These may include:

• Limit use and rest the arm from activities that worsen symptoms.
• Splints or braces may be ordered to decrease stress on the injured tissues.
• Apply ice packs on the elbow to reduce swelling.
• Avoid activities that bring on the symptoms and increase stress on the tendons.
• Anti-inflammatory medications and/or steroid injections may be ordered to treat pain and swelling.
• Physical therapy may be ordered for strengthening and stretching exercises to the forearm once your symptoms have decreased.
• Pulsed ultrasound may be utilized to increase blood flow and promote healing to the injured tendons.

If conservative treatment options fail to resolve the condition and symptoms persist for 6 -12 months, your surgeon may recommend a surgical procedure to treat tennis elbow called lateral epicondyle release surgery. Your surgeon will decide whether to perform your surgery in the traditional open manner (single large incision) or endoscopically (2 to 3 tiny incisions and the use of an endoscope –narrow lighted tube with a camera). Your surgeon will decide which options are best for you depending on your specific circumstances.

Your surgeon moves aside soft tissue in order to view the extensor tendon and its attachment on the lateral epicondyle. The surgeon then trims the tendon or releases the tendon and then reattaches it to the bone. Any scar tissue present will be removed as well as any bone spurs. After the surgery is completed, the incision(s) are closed by suturing or by tape.

Following surgery, you are referred to physical therapy to improve the range of motion and strength of your joint.