Tennis elbow (lateral epicondylitis) is one of the most common elbow conditions treated in an orthopedic practice. The injury is caused by repetitive overuse of the muscles in the forearm. The extensor carpi radials braves muscle attaches on the lateral epicondyle. As micro tears in the muscle occur and the area fails to heal, the tendons attachment becomes inflamed and painful.
Activities contributing to the risk of developing tennis elbow include racquet sports, repetitive or forceful pulling, direct blow to the lateral epicondyle, or work related repetitive motion. Other risk factors include obesity and smoking.
Symptoms & Diagnosis
Symptoms include pain on the lateral aspect of the elbow that is aggravated by gripping, wrist extension, and lifting. Pain can radiate into the forearm and wrist. As the condition worsens, some patients notice weakness in their forearm and in their grip strength.
Diagnosis is made by history and a physical examination. X-rays are sometimes obtained to rule out any bony abnormalities. Ultrasound can be used to visualize the damage in the tendon.
Non-operative treatment includes activity modification, physical therapy and anti-inflammatory medications. Bracing of the forearm is also an option. If symptoms persist, an injection of steroids or PRP can be very helpful. 80-90% of patients improve with conservative care.
Surgical treatment is reserved for tendonitis that fails to improve with all of the available non-operative treatment options. It involves debriedment of the tendon with reattachment to the epicondyle if necessary. There is a short period of immobilization after surgery. Physical therapy is recommended to regain strength and range of motion. Return to full activities is usually 4-6 months.