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Disorders (other than fractures and dislocations) > Lateral Epicondylitis (Tennis Elbow) What is it? Tennis elbow is an inflammation of the tendons that attach the large muscle mass to the forearm to the lateral epicondyle—the bony protrusion on the side of the elbow away from the body. The inflammation is caused by tiny tears in the tendon tissue. The affected muscle mass includes those muscles used to extend your wrist and fingers. The medical term for this condition is lateral epicondylitis. What are the symptoms? A key symptom in tennis elbow is pain directly around the lateral epicondyle. Some people also perceive a weakness which occurs during certain hand and wrist activities that require use of the affected muscles. What causes it? Contrary to popular belief, tennis elbow is not exclusively related to playing tennis. Repetitive use of the forearm, including wrist and finger extension, is the most frequent cause of the disorder. Activities that may aggravate the condition range from sweeping floors to golfing or playing tennis—essentially any arm movement that includes repeated twisting or extension of the wrist. Tennis elbow also may flare up after a single, intense period of overuse. How is it diagnosed? Diagnosis generally starts with a discussion of your condition, fousing on any activities that exacerbate and alleviate your symptoms. Pressure applied to the affected area can cause pain, indicating inflammation and potential tissue damage. Another diagnostic method is the "chair pick-up" test, in which your doctor has you lift a chair in a certain way. This maneuver genrally causes discomfort in the area of the lateral epicondyle in the people who have tennis elbow. X-rays may be taken to rule out other possible sources of pain. How is it treated? Treatment usually starts with restricting any activities that aggravate the condition. Often, your doctor also will splint or brace the affected elbow and wrist to prevent movement. Ice packs, massage and anti-inflammatory modalities may bring relief. If symptoms continue, anti-inflammatory medication may be given orally or by injection to reduce swelling. Surgery is recommended when tennis elbow does not respond to conservative treatment. Surgery for tennis elbow is an outpatient procedure, and is usually done under regional anesthesia. An incision is made on the outside of the elbow thorugh which the doctor is able to remove any diseased tissue. Healthy tissue then begins to heal back to the bone. A portion of the lateral epicondyle also may be removed as a part of the operation. After surgery, your wrist and elbow may be immobilized with a a splint for two to three weeks. Range of motion exercise are recommended on an individual basis, followed by exercises to strengthen arm muscles. Recovey times vary, depending ona ge, general health and length of time tennis elbow symptoms have been present. In general, patients improve with strengthening programs over several months. National Hand Specialists at Union Memorial Hospital can assess your particular case and suggset the appropriate treatment. |