Tennis Elbow – Lateral Epicondylitis
What is Tennis Elbow?
Lateral epicondylitis, commonly referred to as tennis elbow, 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 weakened from small tears as a result of overuse and trauma through activities like swinging a tennis racket against the force of the ball. However, tennis elbow may also develop from compression of one of the nerves in the arm, so a specific diagnosis from one of our Houston specialists is important for proper treatment to be provided.
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.
Overuse is one major cause. 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 most effective 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.
Trauma is another cause of “tennis elbow.” A blow to the elbow or a quick force or movement of the elbow can cause tendon swelling that can degenerate the tendon.
Sign & Symptoms
Tennis elbow – 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. Some of the pain comes from scar tissue which forms and constricts the smooth motion of the tissue.
- Pain on the outer side of the upper forearm, near the elbow
- Lifting, gripping and/or grasping can be painful
- Weakness in the forearm
Diagnosis & Treatment
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: using ultrasound to increase blood flow and doing exercises to build muscle strength can make future strain less likely.
- Extracorporeal shock wave therapy: applying ultrasound externally to create “micro-trauma” to the tendon can promote quicker healing.
- Brace: wearing a brace over the forearm can block the pressure normal activities exert on the tendon, enabling quicker healing.
- Medications: taking aspirin or ibuprofen can help reduce inflammation and pain.
Minimally invasive treatments
- 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.
Non-surgical recovery focuses on rest and reducing swelling.
If we opt for the minimally invasive “No Stitch” approach, it results in little or no scarring, no stitches are required, and patients resume normal activity within about three weeks. A physical therapy program including strengthening will be necessary in order to return to prior activities. Total recovery can be expected to take 4–6 months.
Open surgery includes the same physical therapy, but is a more involved post-surgery care period.