Tennis Elbow

Tennis Elbow or Lateral Epicondylitis

Tennis elbow: Causes, Diagnosis and Treatment
What is tennis elbow?

Tennis elbow is a condition that causes pain on the outside of the elbow. There are tendons that attach to the outside of the elbow, and if these tendons get inflamed or worn out, they can cause pain.

What causes tennis elbow?

The problem got its name from people who were holding their tennis racquets the wrong way so they would put too much stress over their tendons during a tennis game. Overuse of the tendons is the most common cause of tennis elbow, but many patients get tennis elbow from normal use. If the tendon wears out, either from age or overuse, the tendon can cause pain.

What are the symptoms of tennis elbow?

Tennis elbow causes pain over the outside of the elbow during and activity that involves gripping and holding heavy objects with the hand. Many people complain of pain when lifting milk from the refrigerator. Others get the pain when opening jars or performing repetitive tasks with the hands. When the tennis elbow becomes more severe, the pain can be a constant ache that keeps people awake at night.

How is the diagnosis made?

Your doctor can diagnose the problem after listening to your symptoms and performing a careful exam of the elbow, wrist and hand. Xrays can be done to make sure there are no other causes of the pain in the elbow.

What is the treatment?

Tennis elbow is best treated with physical therapy that includes stretching exercises, muscle manipulation and strengthening. A cortisone injection can also help relieve the pain so patients can do more in therapy. A forearm strap can also be worn to take stress off the tendons during activity. This type of treatment can take 3-6 months before the pain goes away.
In some patients, the pain does not improve after therapy and injections. For these patients, surgery may be needed to get rid of the pain in the tendon. Your surgeon will need to determine whether your tennis elbow will improve with surgery. An MRI may be needed to evaluate the tendons of the elbow before the surgeon can decide if surgery will help.

How is surgery performed for tennis elbow?

Dr. Codsi prefers to do the surgery arthroscopically. He will make two small incisions on each side of the elbow and place a camera into the elbow joint. From the other incision, he will use small tools to remove the degenerated portion of the tendon that is causing the pain. Patient can go home the same day of surgery and they will be able to use the arm as soon as the nerve block wears off. The nerve block is given before surgery so that there will be minimal pain after surgery when the patient wakes up.

After surgery, the patient will do stretching exercises to regain all of their motion. Six weeks after surgery, therapy can be started to strengthen the elbow, wrist and hand. Most patients get good pain relief in three months, but it takes a minimum of 6 months of rehabilitation to get complete pain relief.

There are risks from surgery, and these should be considered carefully by the patient before deciding to have surgery. Surgery does not always relieve pain, and any time surgery is performed, there is a minimal risk of infection.