Tennis elbow, or lateral epicondylitis, is one of the most common upper extremity conditions seen in orthopedics today. It is a common tendinopathy classified as an overuse or overstress condition and can be the result of a repetitive activity fatiguing the hand, wrist, forearm or elbow.

The fatigue and stress creates an inflammation that grows increasingly worse over time.

There are over nine million reported cases of tennis elbow in the United States alone every year, though most of those diagnosed with Tennis Elbow have never played tennis. While tennis is the sport for which the condition is named, affecting approximately five in 10 recreational and professional tennis players, the most prominent profile of a tennis elbow patient is the average man and woman between the ages of 40 and 60 – performing everyday activities. A smaller percentage of those diagnosed with tennis elbow, approximately 10 to 20 percent, are those sustaining severe injury resulting from a fall or direct hit to the area.

Tennis elbow actually causes the tendons around the elbow to become inflamed and results in pain at the outside, or lateral side, of the elbow – as opposed to the inside, or medial side, of the elbow associated with a condition known as Golfer’s Elbow, or medial epicondylitis.

Tennis elbow often occurs in the dominant arm. If left untreated, the affected tendon can tear and cause scar tissue to develop. Those suffering from the condition may experience moderate to debilitating pain as the tendon becomes increasingly weaker over time.

Some of the common symptoms of tennis elbow include:

• Pain along the outside of the elbow of the dominant arm – radiating or traveling into the forearm and possibly the hand.
• Pain and subsequent weakness with reaching or grabbing activities.
• Nagging ache and discomfort during rest following activity.

Treatment for tennis elbow can vary depending on the severity of the pain and length of time a patient has suffered from the condition. In Tennis Elbow Part 2, the treatment options available today for tennis elbow sufferers will be discussed – including new autologous blood injections.

Part 2 of 2 part series.

Carpal Tunnel Syndrome, a continued discussion

Last week, a discussion on Carpal Tunnel Syndrome began, as it has become one of the most commonly seen orthopedic conditions affecting the hand today – second only to osteoarthritis.

Those at greatest risk include:

• Women (three times more likely to be affected than men), as CTS affects those subject to high hormone-related conditions such as pregnancy, breastfeeding, menopause and hypothyroidism.
• Those on certain medications such as birth control pills, high blood pressure drugs and cortisone pills or shots.
• Medical conditions such as arthritis, diabetes, Raynaud’s disease and cysts and tumors within the carpal tunnel.

And today’s technologically savvy society seems to be increasingly predisposed to such “overstress” conditions as a result of the handheld device error cementing an electronic dependency that has been growing over the years.  Recognizing that which predisposes us to CTS makes it easier to take preventative measures.

Such preventative CTS steps can be as simple as taking anti inflammatory medication such as Ibuprofen, reducing the amount of time on an activity aggravating the condition and purchasing ergonomic aids for work environments, or as complex as adjusting other medications taken and addressing a primary condition to which it is frequently secondary.

While chronic CTS conditions nonresponsive to conservative treatment may require Dr. Collins’ minimally invasive endoscopic carpal tunnel release, rarely does the condition return once treated.

The endoscopic carpal tunnel release involves a tiny incision made at the base of the hand.  A scope that is inserted illuminates and magnifies the view of the area.  The scope has a small camera attached, which projects images onto a small monitor and guides the doctor through the carpal tunnel.  The transverse carpal ligament forming a band across the wrist is cut slightly in order to relieve the pressure placed on the median nerve as it passes beneath the ligament.

Rehabilitation exercises then help patients quickly return to activity.