LATERAL EPICONDYLITIS (TENNIS ELBOW)
Lateral Epicondylitis or “tennis elbow” is a condition that causes pain on the outside of the elbow and is made worse with lifting and carrying activities. Although it is a very common injury in tennis players, it can affect any individual who uses their arm vigorously or for repetitive activities.
The name Epicondylitis suggests that this injury involves an inflammatory condition, but in fact it is a degenerative condition that results from overuse. The tendons involved are the ones that extend the wrist, and injury of this tendon attachment can occur from overuse with lifting activities. The tendon origin suffers micro-tears from these injuries and fails to heal. This leads to the development of scar tissue at the attachment site.
There are many treatment options for this condition and most involve conservative or non-operative measures. These options include simply rest, ice, use of anti-inflammatory medications, stretching and strengthening. Patients are often referred to physical therapy for direction of an exercise programs as well as treatment with modalities (ultrasound, iontophoresis, friction massage, etc.). Counterforce braces are often recommended as well. When symptoms are severe and/or are not responding to conservative measures, your doctor will often recommend an injection of cortisone which will help alleviate the acute pain and by technique of percutaneous release, stimulate a healing response.
PRP (platelet rich plasma) injections are also a treatment option for those that do not respond to more conservative measures. This involves drawing the a patient’s blood and utilizing a centrifuge to separate the platelet rich component (PRP) of the blood. The PRP is then injected into the injured tendon to stimulate a healing response. This is a very new treatment option but has shown promising results with some studies demonstration >90% success.
When non-operative treatment options fail, surgery is an option to clean out the degenerative tissue and repair the torn tendon. This can be performed with the standard open procedure or can also be performed arthroscopically. If it comes to surgery, Dr. Jones will discuss your options with you and make the best recommendation based on your personal situation.
Following surgery, you will typically be immobilized in a splint for 7-10 days. After this you will be allowed to move your hand, wrist and elbow freely but will be required to limit any physical activity with your arm until approximately 6 weeks after surgery. At this time you will begin a gradual strengthening and conditioning program. It typically takes 4-6 months for a full recovery.
What if I have more questions?
I encourage you to return to the office for further discussion at any time. You can also contact us.