Tennis Elbow

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The elbow is comprised of 3 bones (the humerus, or arm bone, meets the radius and ulna) which form a hinge joint.  The outside (or lateral) area of the elbow can become inflamed after repetitive exercise because nearly all of the muscles that extend your wrist and fingers attach at one point.  Pain can occur after small micro tears and degeneration of the tissue occurs from repetitive movements.  This is called tennis elbow or lateral epicondylitis.

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Tennis elbow is common in 30-50 year olds, and often from non-athletic activities (“But Doc, I don’t play tennis!”).  A similar problem can occur along the inside of the elbow, called medial epicondylitis or golfers elbow.  The treatment is similar to tennis elbow.

Patients will often present with pain on the outside of the elbow worsened with activity or pressure.  Non-operative treatment is fortunately 95% successful; however, it can often take a long time to resolve the symptoms.  I usually recommend a counter brace (pictured) and regular ibuprofen/naproxen use; if this fails one cortisone injection.  I prefer not to provide multiple injections into the area as the ligamentous complex that stabilizes the elbow is close to the injection site and can be disrupted from repetitive injections.

Surgical treatment is offered with worsening symptoms or restrictions after 3 months or a failure of conservative treatment after 6 months. I prefer to do this procedure arthroscopically (picture) but also will perform ultrasound shockwave therapy (so called fast-procedure, or Tenex) in select patients.