Tennis Elbow

What is tennis elbow?

Tennis elbow is otherwise known as lateral epicondylitis. It is a condition affecting the bony lump on the outer side of the elbow joint. This bony lump acts as the attachment site for a group of forearm muscles, responsible for extending the wrist and fingers. These muscles converge to form a common extensor tendon. This tendon attaches to the lateral epicondyle of the bone, causing pain when injured.

What causes tennis elbow?

The condition is often associated with overuse of the tendons, causing trauma within the tissue where it attaches to the elbow. The normal healing process is interrupted, and fibrous (scar) tissue begins to form. The altered tissue within the tendon makes repeated attempts to heal, leaving further painful scar tissue.

Tennis elbow symptoms

Irritation of the tendon can cause pain or tenderness around the outer surface of the elbow, or more commonly at the bony attachment site. This is aggravated during certain movements, such as moving the wrist backwards or repetitive movements involving the hand or wrist, such as typing or using a computer mouse.

How is tennis elbow diagnosed?

A diagnosis of tennis elbow is often confirmed following a thorough medical history and physical examination. Further imaging including x-rays or MRI scans may be used to rule out alternative diagnoses.

Tennis elbow treatment

Non-surgical

Initial treatment includes rest, ice and anti-inflammatory medications. Arm braces can also be effective, particularly alongside physiotherapy. Specific exercises are used to stretch out the tendons and reduce the pull where the tendon attaches to the lateral epicondyle of the bone.

Platelet-rich plasma (PRP) injections are an option when physiotherapy and bracing alone has not been effective. A solution is extracted from the patient’s own blood, rich in growth factors which aid tendon healing.

Steroid injections are successful in relieving symptoms by reducing inflammation however as inflammation is required for the abnormal tissue to heal steroid may increase the overall duration of your symptoms. Therefore while they do have a place steroid injections should be used judiciously following a discussion with your surgeon. Steroid injections can assist with but do not replace physiotherapy exercises.

Surgical

Surgical intervention for tennis elbow is rare. If other treatments are ineffective and other causes of pain have been ruled out, surgery may then be considered. Further imaging including x-rays and scans may be required, to obtain a definitive diagnosis for surgery.

General Information

If you experience severe pain in your elbow when playing tennis or other sporting activities, you may have a tennis elbow injury. Tennis elbow is common with athletes and individuals who tend to perform repetitive motions with their arms. While non-surgical treatments can often provide relief, surgery may be necessary in more severe cases.

Tennis elbow surgery has the aim of relieving pain and restoring a full range of motion in the elbow. The surgery typically involves removing damaged tissue and repairing any tears in the tendon that connects the forearm muscle to the elbow. Recovery time varies depending on the severity of the injury, but most patients can expect to return to their regular activities within a few months. If you’re experiencing chronic pain from tennis elbow, talk to one of our consultants about whether surgery may be the right option for you.