Lateral Epicondylitis / Tennis Elbow

Tennis Elbow

What is it?
Tendonitis at the outside of the elbow is often called tennis elbow. The majority of patients whom we see with this problem do not play tennis excessively. Tennis elbow may be caused by a sudden, acute stress on the elbow or by repetitive motion activities involving picking up objects with the palm facing downwards or inwards.

Causes:
Whenever you pick something up with your palm facing downwards or inwards, the muscles on the back of the forearm contract and do most of the work. Most of the muscles on the back of the forearm attach to the tendon on the outside of the elbow. When these muscles contract they put stress on this tendon. It is important to change the way you pick up and carry things. You must think of carrying things with two hands rather than one. This decreases the stress on each arm. Carrying things with the palm up puts stress on the muscles on the palm side of the forearm. These muscle attach to the inside of the elbow. Containers of liquid such as milk, orange juice, etc. should be smaller and should be picked up with both hands.

Treatment:
The first line of treatment is to eliminate chronic stress on the tendon which attaches to the outside of the elbow.

Cortisone shots are often effective in reducing the amount of pain and inflammation. Unfortunately cortisone shots in this area often hurt. Anti-inflammatory medication can also be of value. If several cortisone shots and anti-inflammatory medications are unsuccessful in curing this problem. There is a surgical option, and an option for platelet rich plasma (PRP). The tendon on the outside of the elbow is explored. If the area of chronic inflammation is seen, it is removed. If no specific area of inflammation is found, the tendon is lengthened a small amount to decrease stress and tension on the tendon. The results from this operation are not universally good.