Known by physicians as lateral epicondylitis, Tennis Elbow affects the lateral, or outer, portion of the elbow and results when the elbow is overstressed or repetitively overused.
The forearm muscles that bend the wrist back (the extensors) attach at the lateral epicondyle (bony bump at the outer portion of the elbow) and are connected by a single tendon. Lateral epicondylitis is the irritation and subsequent inflammation of the tendon around the lateral epicondyle, or bony elbow bump, thought to be the result of tissue degeneration within the tendon.
Initially moderate pain is felt at the outer portion of the elbow. Over time pain increases and may spread down the forearm and to the back of the middle and ring fingers – eventually causing debilitating pain and weakness in arm function. Reaching and grasping activities may become painful, and a nagging discomfort may be present while resting after activities.
Those at Risk
While it got its name because five in 10 recreational and professional tennis players suffers from the condition, the average man and woman between the ages of 40 and 60 is far more likely to suffer from the condition doing everyday activities – painting with a brush or roller, using a chain saw or hand tools, pruning shrubs, lifting children up and down. The overuse of the muscles and tendons of the forearm and elbow is likely to prompt the condition.
In diagnosing tennis elbow, patient history and a pain analysis are generally followed by a physical exam that places the arm and wrist in various positions that require the forearm muscles and tendons to stretch. An X-ray may be indicated in order to eliminate other causes of elbow pain. A magnetic resonance image (MRI) or ultrasound test may also be used in establishing and confirming diagnosis.
Beginning always with conservative nonsurgical treatment for such conditions, a plan to prevent further degeneration and promote an environment conducive to tendon healing is established. This may entail a course of anti-inflammatory medications if acute inflammation is determined. A physical or occupational therapy program helps instruct patients on ways to perform activities without placing strain on the elbow.
And recently available to patients suffering from chronic tennis elbow nonresponsive to traditional conservative treatment options is a new noninvasive high-energy shockwave therapy. This nonsurgical procedure is called the OssaTron Treatment and is performed as an outpatient procedure that takes less than 20 minutes.
When the condition is nonresponsive to conservative treatment and not conducive to shockwave therapy, surgery may be indicated, in order to relieve the tension from the extensor tendon. This procedure is called lateral epicondyle release and can also be done as outpatient.