Tennis elbow is a degenerative condition of tendon fibers that attach on the bony prominence (epicondyle) on the outer side of the elbow. These tendons anchor the muscles that extend or lift the wrist and hand (see figure). To view all the information on tennis elbow please view the following: non-surgical treatment, surgical treatment, frequently asked questions and Rehabilitation.
The problem occurs generally between the ages of 30 and 50, although it can happen at any age. The name is derived from that fact that about half of athletes in racquet sports may incur this problem, even though most of the time no specific injury has previously occurred. Most patients with tennis elbow, however, are not active in racquet sports at all. Many are involved in work or recreational activities that require repetitive and vigorous use of the forearm muscles, like meat cutting, plumbing, raking or weaving. Some develop tennis elbow without any recognizable cause.
Symptoms
Patients often complain of severe, burning pain on the outer part of the elbow that gradually increases over time. Pressing on this site or gripping or lifting objects makes the pain worse. Lifting even things as light as a small book or a cup of coffee can lead to significant discomfort. In severe cases, the pain can radiate to the forearm with any arm movement.
In fact, x-rays are generally not needed to diagnose tennis elbow. In rare cases, however, MRI (magnetic resonance imaging) scans may be used to show changes in the tendon at the site of attachment to the bone.
As pain relief is the main goal in the first phase of treatment, the doctor may advise you to stop any activities that cause symptoms. You may need to apply ice to the outer part of the elbow. You may also need to take acetaminophen or an anti-inflammatory medication for discomfort.
Orthotics such as counterforce braces or wrist splints can help reduce symptoms by resting the muscles and tendons.
If symptoms have not significantly improved within four weeks, the doctor may administer a corticosteroid injection around the outside of the elbow. This is a relatively safe procedure but repeated injections should be avoided to prevent further degeneration of the tendon and wasting of the fatty tissue below the skin.
After pain is relieved, patients should modify activities in an effort to keep symptoms from returning. In addition, the doctor may recommend physical therapy, including stretching and range of motion exercises and gradual strengthening of the affected muscles and tendons.
Non-operative treatments are successful in about 85 percent to 90 percent of patients with tennis elbow.
Surgical treatment is considered for patients with incapacitating pain that does not get better after at least six months of non-operative treatment.
The surgical procedure involves removing diseased tendon tissue and reattaching normal tendon tissue to bone. This is done through a small incision on an outpatient basis under regional or general anesthesia but does not require an overnight hospital stay.
• How soon after surgery can I start to bend my elbow?
Light, gradual exercises are started two months after surgery.
• How soon may I be able to return to athletic activity?
Usually four months to six months, on your doctor's advice.
• What is the success rate for this procedure?
Tennis elbow surgery is considered successful in about 90 percent of patients.
The source for this information is the American Academy of Orthopaedic Surgeons.