Tennis Elbow

Tennis elbow is the common name used for the elbow condition, lateral epicondylitis. It is an overuse injury that causes the inflammation of tendons that attach to the bony prominence on the outside of the elbow (lateral epicondyle).

It is a painful condition occurring from repeated muscle contractions at the forearm, leading to inflammation and micro tears in the tendons that attach to the lateral epicondyle. The condition is more common in sports activities such as tennis, painting, hammering, typing, gardening and playing musical instruments. Patients with tennis elbow experience elbow pain or burning that gradually worsens and a weakened grip.

Your doctor will evaluate tennis elbow by reviewing your medical history, performing a thorough physical examination and ordering X-rays, MRI or electromyogram (EMG) to detect any nerve compression.

Your doctor will first recommend conservative treatment options to treat the tennis elbow symptoms. These may include:

• Limit the use and rest the arm from activities that worsen the symptoms.
• Splints or braces may be ordered to decrease stress on the injured tissues.
• Apply ice packs on the elbow to reduce swelling.
• Avoid activities that bring on the symptoms and increase stress on the tendons.
• Anti-inflammatory medications and/or steroid injections may be ordered to treat pain and swelling.
• Physiotherapy may be ordered for strengthening and stretching exercises once your symptoms have decreased.
• Pulsed ultrasound may be recommended to increase blood flow and promote healing to the injured tendons.

If conservative treatment options fail to resolve the condition and symptoms persist for 6-12 months, your surgeon may recommend a surgical procedure called lateral epicondyle release surgery to treat tennis elbow. Your surgeon will decide, depending on your specific circumstances, whether to perform your surgery in the traditional open manner (single large incision) or endoscopically (2 to 3 tiny incisions and the use of an endoscope, a narrow lighted tube with a camera).

The procedure involves moving aside the soft tissues to view the extensor tendon and its attachment on the lateral epicondyle. Your surgeon then trims the tendon or releases it and reattaches it to the bone. Any scar tissue or bone spurs present will be removed. After the surgery is completed, the incision(s) are closed by suturing or tape.

Following surgery, you are referred to physiotherapy to improve the range-of-motion and strength of your joint.