Denver Shoulder - Tennis Elbow (Lateral Epicondylitis)

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Tennis Elbow (Lateral Epicondylitis)

Lateral epicondlyitis, or tennis elbow, is a painful inflammation of the tendons along the lateral (or outside) aspect of the elbow. On the outside of the elbow are a group of tendons that control the hand and wrist during grip and with bringing the wrist back towards the elbow (wrist extension). One tendon in particular, the extensor carpi radialis brevis (ECRB) constantly tries to control the wrist during grip and wrist motion. In certain individuals, this tendon may become inflamed and swollen from overuse, such as a tennis player performing many backhand strokes. 

Who typically develops tennis elbow?

Tennis elbow may develop in anyone; however, it is most commonly seen in patients who perform repetitive motion with their hand and forearm. This may include motions such as backhand in tennis or using a screwdriver. These motions cause inflammation in the tendons that support and extend the wrist, resulting in pain.

What are the common symptoms associated with tennis elbow?

The most common symptom associated with tennis elbow is pain along the lateral (outside) aspect of the elbow. This pain typically occurs with activities, but may also occur at rest or at night. The pain may also radiate up towards the shoulder or down towards the hand. Other symptoms may include difficulty in straightening the elbow or burning along the forearm. 

How is tennis elbow typically treated?

Most patients are treated without surgery. Initial treatment includes ice, rest, and compression of the involved area. Anti-inflammatory medications including ibuprofen, meloxicam, or diclofenac can help limit day-to-day pain. Exercises that are either initiated at home or with an occupational therapist are used to stretch and strengthen the involved tendons. Sometimes a steroid injection can be used to reduce inflammation around the diseased tendon. Sometimes it may take up to six months of treatment for the pain to completely resolve. Rarely (less than 10% of patients) does this treatment regimen not resolve the pain. These patients are considered to have recalcitrant lateral epicondylitis and may require surgery.

What are the surgical options for treating tennis elbow?

There are several surgical options for this disease. Depending on patient characteristics, an open procedure or an arthroscopic procedure may be used. Ultimately, the goal of surgery is to remove diseased tendon in the ERCB and establish an environment that allows for tendon healing. This can be done by creating small holes in the bone that encourage bleeding at the area of the surgery, or even with a small muscle transfer that improves the blood supply to the area. After surgery, patients are commonly places into a splint for a short period of time and then are started on a range of motion exercises. Patient will have a weight bearing restriction for up to six to eight weeks after surgery, and most people show gains for over three to four months after the surgery.

To learn more about tennis elbow, or to schedule an appointment with one of our specialty-trained elbow doctors at Western Orthopaedics, please call (303) 321-1333.


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