Lateral Epicondylitis (Tennis Elbow)
Elbow Anatomy
The elbow joint connects the humerus, ulna, and radius bones and allows the arm to move with a hinge-like motion. The lateral epicondyle is a small, bony projection on the outer part of the humerus. It is the attachment site of the tendons of the forearm muscles that extend the wrist and fingers.Â
These muscles are responsible for gripping and lifting and are highly active during activities such as tennis, carpentry, and using a computer mouse. Repetitive or continuous use of these muscles can cause microscopic tears in the tendons, leading to tissue degeneration and inflammation. This condition is known as lateral epicondylitis or “tennis elbow.”
Tennis Elbow
Lateral epicondylitis or tennis elbow is a condition caused by degenerative changes to the tendons that attach to the lateral epicondyle. It is a common injury among athletes, particularly in tennis players.
However, it can develop in any individual who repeatedly uses their forearm extensor muscles, such as carpenters, gardeners, and painters. The most common symptom of tennis elbow is pain or tenderness on the outside of the elbow and a weak grip strength. In severe cases, the pain can extend to the wrist and forearm, making it difficult to perform daily activities.
Treatments
Non-surgical or conservative treatments are often used for the initial management of tennis elbow. Resting the affected arm, using ice, and taking nonsteroidal anti-inflammatory drugs (NSAIDs) can help to decrease inflammation and pain. Physical therapy and stretching exercises can help to strengthen and stretch out the forearm muscles and take pressure off the affected tendon. A counterforce brace or strap can also be used to alleviate the load on the tendon.
If these treatments are not effective, corticosteroid injections are also an option. Surgical intervention may be necessary if non-invasive methods are not successful, or if the pain is severe and hinders the individual’s daily activities. Dr. Christopher Jones, an experienced physician, can provide an individualized treatment plan for those suffering from tennis elbow.
Non-Surgical Treatments
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 as physical therapy for the direction of 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 the technique of percutaneous release, stimulate a healing response.
Surgical Treatments
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.
Recovery
Following surgery, it is important to properly manage the recovery process. The recovery time for tennis elbow surgery usually lasts for 4-6 months. After surgery, the arm may be immobilized in a splint or sling to protect the surgical site and promote healing. Physical therapy and rehabilitation exercises will begin only when the stitches and splint have been removed.
The range of motion will gradually be increased, and patients will be gradually introduced to strengthening exercises. Returning to activities and sports will be a gradual process. Patients must consult with their doctor before resuming any activities to avoid re-injury. Dr. Christopher Jones is an experienced physician who can recommend the appropriate recovery plan and answer any questions regarding tennis elbow or other conditions.