Tennis elbow is a condition that arises from irritation of the extensor tendons that arise at the lateral elbow. This is why it also called lateral epicondylitis. In some cases the medial side of the elbow also be involved. Typical symptoms are pain and tenderness on the lateral elbow, which is worsened by wrist extension. If the medial elbow is also affected then symptoms may also include pain with wrist flexion.
Tennis elbow unlike its name occurs more commonly in athletes of other sports much more commonly.
It is important to make the correct diagnosis because other conditions can cause similar symptoms and therefore must ruled out or investigated. One of those conditions can be compression of the radial nerve distal to the radial head, a condition called radial tunnel syndrome. Tennis elbow and radial tunnel syndrome however can co-exist.
The most common cause of tennis elbow is a tear of the common extensor origin at the lateral epicondyle. The diagnosis however can be tricky, as a tear in the common flexor origin can exist at the medial epicondyle.
Initial therapy for tennis elbow includes anti-inflammatory medicines, rest, physical therapy and resting of possible. Cortisone injections can be used to calm down the inflammation if it’s associated with unremitting pain. Usually these treatments especially the cortisone injections will suffice. Surgical therapy is indicated in about 10% of patients. May patients are willing to endure pain for months to years in order to avoid surgery. Athletes and workers who rely on their hands elect to have definitive surgical therapy much sooner if symptoms do not subside with medical therapy.
Surgical therapy consists of exploration of the elbow, excising the diseased parts of the tendons, tendon repair, removing inflammatory tissue, minimal epicondyle bone resection and then re-attachment of the tendons.
Postoperative care involves the application of a splint for a month. The splint extends from the axilla to the hand. After 6 weeks resistive exercises and arm strengthening exercises begin. Athletes are treated the same way too. Eventually there is no restriction to heavy-duty activity.