Lateral Epicondylitis (Tennis Elbow)
Tennis elbow has become more widespread in the general population due to more active fitness lifestyles. In fact, in the United States, tennis elbow now impacts 1% to 3% of the total population.
The technical name for Tennis Elbow is lateral epicondylitis. It causes pain on the outside of the elbow that can radiate into the forearm. Tennis elbow pain can range from a minor intermittent ache to debilitating pain.
Sometimes the pain can be severe enough to make lifting a full coffee mug difficult. Only an occasional sufferer of Tennis Elbow actually plays tennis and the reason lateral epicondylitis became known as Tennis Elbow is not clear.
Tennis Elbow is a painful condition of a tendon at its attachment to the normal bump that is on the outside of everyone’s’ elbow. The bump is called the lateral epicondyle and is a part of the long bone that goes from the shoulder to the elbow.
The other end of the tendon is connected to muscles that move the wrist. Wrist motion can be painful in severe case of tennis elbow. But the most significant pain is always directly over the lateral epicondyle.
There are several treatment options for tennis elbow that your orthopaedic surgeon, who is skilled in the care of hand and arm conditions, may suggest. These include activity limitation, bracing, oral medications such as steroids and anti-inflammatory pills, steroid injection and physical therapy. Platelet Rich Plasma injection has been used as a treatment. However this injection has not yet received widespread acceptance.
Surgery may be considered if several months of treatment do not adequately alleviate the pain.
What are the Causes of Tennis Elbow?
Tennis elbow can occur secondary to direct trauma. Many people report symptoms after striking the elbow. Repetitive activities such as chopping or turning wrenches can lead to tennis elbow. Sometimes a quick forceful twisting motion of the arm can be a cause. In rare circumstances, Tennis Elbow can be associated with a disease such as rheumatoid arthritis. It is also common for tennis elbow to occur with no identifiable cause. Most cases are diagnosed in people between the ages of 30 and 50.
The pain associated with tennis elbow can radiate from the outside of the elbow to the forearm and wrist, or up the arm. In severe cases it may become difficult to perform everyday tasks such as shaking hands, turning a doorknob, or holding a cup of coffee.
Often the symptoms of Tennis Elbow develop gradually and worsen with activity. But the pain can begin suddenly with a forceful activity or trauma.
What are Nonsurgical Treatment Options for Tennis Elbow?
Most patients who are suffering from tennis elbow have success with nonsurgical treatments such as;
- Resting the arm and limiting heavy activities for a while, which can help the pain to subside
- Steroid injections directed at the area of pain on the lateral epicondyle can be an effective treatment
- Non steroidal anti-inflammatory medication and steroid pills such as meloxicam, naproxen, and prednisone can reduce pain, inflammation, and swelling
- Physical therapy can be an effective aid in diminishing the inflammation and regaining arm strength.
- Orthotics such as an elbow pad or wrist splint often help to relieve Tennis Elbow symptoms.
What Surgical Treatments Exist for Tennis Elbow?
After several months of care, surgery may be considered if pain persists. The decision to operate for tennis elbow is made based on the degree of pain. How the pain affects normal daily activities is an important factor to consider.
There are several different surgical techniques to help tennis elbow pain. They all involve a similar mechanism done with small incisions. An arthroscopic approach can be used in some cases.
If conservative treatment methods prove unsuccessful, your doctor may recommend surgery.
“Typically, in my practice, I’ll do one or two cortisone injections and if that’s successful with the therapy, then the patient is cured,” says Dr. Reuss. “But if not the patient has to undergo a surgery called an ‘open lateral release’, where we release the tension on those tendons and ligaments.”
What is Recovery Like After Surgery for Tennis Elbow?
Following surgery a bandage is placed on the arm. Physical activity is restricted. After about ten days the sutures and bandage are removed. Physical therapy is often utilized to help restore motion and strength. Activities that utilize the arm are slowly increased over time. After recovery most patients are significantly improved. Maximum recovery can take four to six months.