One of the most common sources of elbow pain is tennis elbow. Tennis elbow, also called “lateral epicondylitis,” is a painful condition affecting many adult patients. Tennis elbow is caused by degeneration within the extensor carpi radialis brevis (ECRB) tendon on the outside of the elbow (lateral aspect). Despite the name, tennis elbow is not just limited to tennis players. In fact, tennis elbow is commonly diagnosed in patients between the ages of 30 and 50, and many patients have never played tennis.
Patients feel pain on the outside of the elbow and often point to a very tender spot near the lateral epicondyle bone (see image below). Symptoms can be aggravated by a forceful, repetitive activity with the hand and wrist, such as the tennis backhand swing or heavy gripping. Lifting light objects, gripping the steering wheel, and even simple household activities can be painful at times. Fortunately, the majority of patients with tennis elbow improve with non-operative treatment, although symptoms often take several weeks or months to resolve.
Golfer’s elbow, or “medial epicondylitis,” is a similar condition which causes pain on the medial, or inside, of the elbow. Both elbow pain conditions can be diagnosed in the office based on your symptoms, physical exam, and x-rays. MRI is typically not required to make the diagnosis.
What are the non-operative treatment options for tennis elbow?
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Braces: Wearing a forearm strap or wrist splint
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Activity modification: Resting, avoiding repetitive, heavy lifting or forceful gripping
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Medications: Taking anti-inflammatory medications such as Motrin, Naproxen, or Tylenol
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Stretches: Stretching the muscles of the hand, wrist, and elbow with exercises
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Hand Therapy: A therapist can guide tennis elbow exercises and perform iontophoresis, ultrasound, or therapy modalities
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Corticosteroid injection: Anti-inflammatory medication injection targeting the degenerative ECRB tissue can reduce pain
When is surgery recommended?
If non-operative treatment fails to improve the elbow pain after several months of conservative treatment, surgery may be recommended. During the outpatient surgery, a small portion of degenerative ECRB tissue is removed or “debrided.” This procedure is thought to stimulate healing of the normal surrounding tissues while removing the painful degenerative tissue. The type and length of incision varies among surgeons. This surgery is not a “quick fix” since returning to sports, heavy work, or weight training can take several months and additional therapy.
What are the results from surgery?
Most patients experience a significant reduction in pain, report improved function, and are satisfied with the outcome after tennis elbow surgery. However, not all patients experience complete pain relief and recovery can take several weeks to months.
Raleigh Hand Center doctors treat tennis elbow and other disorders of the hand and arm. Please call our office to be evaluated by an upper extremity specialist.