Tennis Elbow (Lateral Epicondylitis)
Tennis elbow, or lateral epicondylitis, is the most common injury in patients seeking medical attention for elbow pain. The exact cause of tennis elbow is unknown, but it is thought to be due to small tears of the tendons that attach forearm muscles to the arm bone at the elbow joint. The muscle group involved, the wrist extensors, function to cock the wrist back. Specifically, the extensor carpi radialis brevis has been implicated in causing the symptoms of tennis elbow.
Patients with tennis elbow syndrome experience pain on the outside of the elbow that is worsened by grasping objects and cocking back the wrist.
Most patients are between the ages of 35 and 65 years old. It commonly affects manual workers and people who play racquet sports.
The most common symptoms of tennis elbow are:
- Pain when lifting objects
- Pain on playing sports – racquet sports in particular
This pain commonly is felt on the outside of the elbow and radiates down the back of the forearm to the wrist. The symptoms often worsen over time.
Treatment starts with activity assessment and modification. A tennis player’s symptoms could resolve by something as simple as changing racquets. In conjunction with anti-inflammatory medication, physiotherapy and steroid injections, many patients recover fully without the need for surgery. However, some severe cases are resistant to the measures and require surgery. Surgery to release the damaged tendon is usually successful, but rarely needed; about 95 percent of patients with tennis elbow can be treated without surgery.
If surgery is needed, the surgical release is performed as a day-case operation. The location of the tendon damage is identified through a small incision, and this portion of the tendon is removed. The underlying bone is exposed, and blood flow to this region is stimulated. The remaining tendon is repaired by using sutures anchored into the bone.