Tennis Elbow

Tennis elbow is a common name used for lateral epicondylitis, an overuse injury that causes inflammation of the tendons that attach to the bony prominence on the outside of the elbow (lateral epicondyle). It is a painful condition that occurs from repeated muscle contractions at the forearm, leading to inflammation and micro-tears in the tendons that attach to the lateral epicondyle. The condition is more common with tennis and in activities such as painting, hammering, typing, gardening and playing musical instruments. Patients with tennis elbow experience elbow pain or a burning sensation that gradually worsens, and results in a weakened grip.

Your doctor will evaluate your tennis elbow by reviewing your medical history, performing a thorough physical examination, and ordering X-rays, MRI or electromyogram (EMG) to detect any nerve compression.

Your doctor will first recommend conservative treatment options to treat the tennis elbow symptoms. These may include:

• Limit use and rest the arm from activities that worsen symptoms.
• Splints or braces may be ordered to decrease stress on the injured tissues.
• Apply ice packs on the elbow to reduce swelling.
• Avoid activities that bring on the symptoms and increase stress on the tendons.
• Anti-inflammatory medications and/or steroid injections may be ordered to treat pain and swelling.
• Physical therapy in the form of exercises may be ordered for strengthening and stretching the forearm once your symptoms have decreased.
• Pulsed ultrasound may be performed to increase blood flow and promote healing of the injured tendons.

If conservative treatment options fail to resolve the condition and symptoms persist for 6-12 months, your surgeon may recommend a surgical procedure to treat tennis elbow called lateral epicondyle release surgery. Your surgeon will decide whether to perform your surgery in the traditional open manner (single large incision) or endoscopically (2 to 3 tiny incisions and the use of an endoscope, which is a narrow lighted tube with a camera). Your surgeon will decide which option is best for you depending on your specific condition.

During surgery, your surgeon moves aside the soft tissues in order to view the extensor tendon and its attachment on the lateral epicondyle. The surgeon then trims or releases the tendon, and reattaches it to the bone. Any scar tissue present will be removed as well as any bone spurs. After the surgery is completed, the incision(s) are closed by suturing or tape.

Following surgery, you are referred to physical therapy to improve the range of motion and strength of your joint.