Lateral epicondylitis is a painful condition of the outer top side of the forearm, near the elbow. It is usually characterized by inflamed extensor tendons, which connect to the extensor muscles that ultimately are used to straighten your fingers. These tendons, which connect the elbow joint to the forearm muscles, may be strained or may have small tears as a result of overuse and trauma through activities like swinging a tennis racquet against the force of the ball. Lateral epicondylitis may also develop from compression of one of the nerves in the arm, however, so a specific diagnosis from one of our Houston specialists is important for proper treatment to be provided.
Tennis elbow is the common name for the elbow condition lateral epicondylitis. It is an overuse injury that causes inflammation of the tendons that attach to the bony prominence on the outside of the elbow. It is a painful condition occurring from repeated muscle contractions in the forearm that leads to inflammation and microtears in the tendons that attach to the lateral epicondyle. The lateral epicondyle is the bony prominence that is felt on the outside of the elbow and the condition is more common in sports individuals playing tennis.
Lateral Epicondylitis can range from a nuisance to extremely painful and may limit normal activities, since we rely on flexible hand use for most of our work and play.
Common symptoms treated by our Houston specialists are:
- Pain on the outer side of the upper forearm, near the elbow.
- Weakness in the forearm
Some of the pain comes from scar tissue which forms and constricts the smooth motion of the tissue.
Nicknamed "tennis elbow" because the repeated swinging motions in tennis can trigger it, lateral epicondylitis is by no means limited to tennis or sports-related causes. Repeated finger movements on a mouse or keyboard are a common cause or aggravator of tennis elbow, and with age, we are more susceptible to strain with less provocation. As with most tendon, ligament or muscle strains, the best avoidance tactics are to start new exercises and sports gradually, "listen" to your body when discomfort or pain sets in, and rest the affected areas before resuming that activity.
Numerous treatment options are available in our Houston offices and can be effective in treating most cases of lateral epicondylitis.
- Rest: stopping the repetitive activity that caused the condition can relieve the symptoms.
- Physical therapy: ultrasound to increase blood flow and exercises to build muscle strength so that future strain is less likely to be prescribed.
- Extracorporeal shock wave therapy: ultrasound is applied externally to create "micro-trauma" to the tendon, promoting quicker healing.
- Brace: worn over the forearm, a brace can block the pressure normal activities exert on the tendon, enabling quicker healing.
- Medications: aspirin or ibuprofen can be helpful in reducing inflammation and pain.
Minimally invasive treatments include:
- Steroid injections: Cortisone is injected into the tendon and surrounding areas to reduce inflammation and speed healing.
- Arthroscopic surgery: An arthroscope is threaded through small incisions to release fascia and scar tissue that constrict tissue and causes pain.
- Tenex procedure: A tiny endoscope, guided by ultrasound, is threaded through a small incision and ultrasound waves are then applied to break up tissue causing constriction.
Open surgery takes only a few minutes and involves making an incision over the elbow to release tight white fascia and release or remove scar tissues that are causing pain.