Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis), is a painful condition of the elbow caused by overuse. Playing tennis or other racquet sports can cause this common tennis injury condition. It is also very common in golfers.
Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow while golfer’s elbow is an inflammation of the tendons on the inside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.
Having a better understanding of the causes and symptoms of tennis elbow pain can help you take preventive measures and decide on tennis elbow treatment methods.
We will talk to you about what activities cause symptoms and where on your arm the symptoms occur. Be sure to tell us if you have ever injured your elbow. If you have a history of rheumatoid arthritis or nerve disease, do tell us.
During the examination, we will use a variety of tests to pinpoint the diagnosis. For example, we may ask you to try to straighten your wrist and fingers against resistance with your arm fully straight to see if this causes pain. If the tests are positive, it tells us that those muscles may not be healthy.
Although tennis and golfer’s elbow is largely a clinical diagnosis, we may recommend additional tests to rule out other causes of your problem.
These may be taken to rule out arthritis of the elbow.
Magnetic Resonance Imaging (MRI)
In chronic cases that have been present for a long time, we may order an MRI scan to look for tears of the affected tendons. This will affect the treatment plan.
Nonsurgical Tennis Elbow Treatment
Approximately 80% to 95% of patients have success with nonsurgical treatment.
The first step toward recovery is to give your arm proper rest. This means that you will have to stop participation in sports or heavy work activities for several weeks.
- Non-steroidal anti-inflammatory medicines
Drugs like aspirin or ibuprofen reduce pain and swelling.
- Wrist stretching exercises
- Equipment check
If you participate in a racquet sport, your doctor may encourage you to have your equipment checked for proper fit. Stiffer racquets and looser-strung racquets often can reduce the stress on the forearm, which means that the forearm muscles do not have to work as hard. If you use an oversized racquet, changing to a smaller head may help prevent symptoms from recurring.
Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce tennis elbow pain and symptoms by resting the muscles and tendons.
- Steroid injections
Steroids, such as cortisone, are very effective anti-inflammatory medicines. Your doctor may decide to inject your damaged muscle with a steroid to relieve your symptoms.
- Radial shockwave therapy (RSWT)
During this procedure, high-energy shockwave impulses stimulate the healing process in damaged plantar fascia tissue. Each session takes about 15 minutes and acute conditions usually require around 5-6 sessions (once or twice weekly) while chronic conditions usually require 8 or more sessions. RSWT is noninvasive—it does not require a surgical incision. Because of the minimal risk involved, RSWT is often tried before surgery is considered.
Surgical Tennis Elbow Treatment
If your symptoms do not respond after 6 to 12 months of nonsurgical treatments, your doctor may recommend surgery. The right surgical approach for you will depend on a range of factors. These include the scope of your injury, your general health, and your personal needs..
- Open surgery (tennis elbow release)
The most common approach to tennis elbow treatment repair is open surgery. This involves making an incision over the elbow and removing diseased muscle and tendon and reattaching healthy muscle back to bone. Open surgery is usually performed as an outpatient surgery. It rarely requires an overnight stay at the hospital.
- TOPAZ Treatment
TOPAZ is a quick, simple and minimally invasive medical technique now available for the treatment of chronic tendon problems. The TOPAZ MicroDebrider utilizes patented Coblation® technology, designed to specifically treat tendons and fascia. To date, over 5 million Coblation procedures have been performed. The TOPAZ technique has been associated with quick return to daily activities allowing for significant improvement in patient outcomes.
TOPAZ treatment typically takes less than 20 minutes to administer. This can be done under local anaesthesia and light sedation and patients can go home about 1-2 hours after the procedure. TOPAZ provides patients with a minimally invasive alternative to surgical debridement and potentially allows for quick return to activities of daily living.
As with any surgery, there are risks with tennis elbow surgery. The most common things to consider include:
- Nerve and blood vessel damage
- Possible prolonged rehabilitation
- Loss of strength
- Loss of flexibility
- The need for further surgery