What is it?
Lateral epicondylitis, more commonly known as tennis elbow, is a painful condition involving muscles and tendons that attach to the bony prominence (epicondyle) on the outside (lateral) part of the elbow. Tennis elbow treatment doesn’t require surgery except in the most extreme cases. The muscles involved in this condition function to straighten and stabilize the wrist. With lateral epicondylitis there is a degeneration and weakening of the muscle and of the tendon attachment. This area becomes tender to touch. Pain is produced with activities including lifting or gripping. The pain can be severe, sometimes even radiating from the elbow to the hand, and, occasionally, pain can occur with any motion of the elbow.
What causes it?
Science doesn’t understand why people get lateral epicondylitis. There appears to be a connection to overuse. Tennis elbow is particularly common in people in their forties and fifties. People know it as tennis elbow, but most who have it aren’t tennis players. Although we refer to the condition as inflammation, it is more accurately described as degeneration.
How is it diagnosed?
Pain on the outside of your elbow, often after increased activity level is the most common presentation of lateral epicondylitis. X-rays or MRIs are not usually necessary.
What are the treatments?
At Florida Hand Center we have a three-pronged approach to the initial treatment of lateral epicondylitis including the use of a brace, occupational therapy, and activity modification. Response to treatment can be very slow, sometimes taking up to six months or longer. Anti-inflammatory medications and topical treatments like ice, heat, or creams may also be used. Cortisone injections should be reserved for patients that don’t improve with occupational therapy. The treatment goal is to teach symptom or pain management, as recurrence of pain will commonly occur.
Surgery is considered as treatment only when the pain is incapacitating, has not responded to good conservative care, and symptoms have lasted more than six months. Surgery involves removing the diseased, degenerated tendon tissue, and is usually performed in an ambulatory surgery center. Please note that the results of surgery are inconsistent, hence the motivation to do everything possible to avoid an operation. Sometimes permanent activity modifications including changing your job or hobbies are necessary to control the pain. Recent studies have suggested that in most cases the symptoms will improve over time.