What is Tennis Elbow?
Tennis elbow, also known as lateral epicondylitis, is a major cause of pain along the outer elbow. Pain is usually worse with activities such as gripping, or with repetitive wrist motions. Patients with this condition often have tenderness along the outer (lateral) part of the elbow, particularly over the bony point, which is also known as the epicondyle. Epicondylitis is somewhat of a misnomer, in that there is very little actual inflammation within the tendon. The collagen within the tendon becomes disorganized, new blood vessels develop and that is what leads to the pain.
What to Expect During Examination
On exam, patients will usually have pain with resisted extension of the wrist and fingers. X-rays tend to be normal, but can show some signs of calcification. MRIs usually do not give any useful diagnostic information unless there are concerns for other causes of the pain.
There is a four phased approach to treatment of this condition. Physical therapy is often all that is needed to treat the condition. Often a wrist brace or an offloading counterforce strap can provide relief with certain aggravating activities. If that fails, topical or oral anti-inflammatories can also be beneficial. Injections are the next step in treatment. Injections can consist of steroid to the surrounding tissue to help with the local inflammation, but the latest studies show that PRP (platelet rich plasma) has the best long term results in regards to actual resolution of symptoms. Finally, when all else fails, surgery is an option, however, many patients do not find consistent relief with the procedure, and many surgeons prefer to not perform this procedure.
Dr. Natan Bastoky is a Non-Operative Sports Medicine Physician in Fort Lauderdale, FL. He is dual board-certified in Family Medicine and Sports Medicine. To learn more about Dr. Bastoky or to book a consultation, click here.