Tennis Elbow Treatment Orange County

Elbow Surgeons Ready to Help Ease Your Pain

Tennis elbow, medically known as lateral epicondylitis, is an inflammation of the tendons that join the forearm muscles (radius and ulna) on the outside of the elbow. Damage of the forearm muscles and tendons are caused by overuse — degeneration, tears, or similar injuries from repeating the same motions repeatedly. This leads to pain, tenderness and elbow joint weakness.

Do I Have Tennis Elbow?

The reason tennis players are susceptible to tennis elbow is due to repetitive arm, elbow and wrist work that is a result of constantly hitting tennis balls with their racquets. Although it is most commonly associated with tennis and other racquet sports, tennis elbow also affects other athletes and workers who participate in activities involving repeated contraction of the forearm muscles that are used to straighten and raise the hand and wrist. Other sports such as golf, baseball and bowling also have a high incidence of tennis elbow.

Tennis elbow is most common among:

• Plumbers
• Painters
• Carpenters and mechanics
• Assembly line workers
• Cooks or butchers
• Gardeners
• Professions involving repetitive computer use
• Jobs that require vacuuming, sweeping and scrubbing

Symptoms of tennis elbow may include:

• Mild outer elbow pain that gradually worsens over days or weeks
• Pain and weakness that worsens when gripping an object, shaking hands or turning a doorknob
• Forearm activity worsens the pain and/or weakness symptoms

Diagnosis of Tennis Elbow

At your physical exam, your elbow doctor will consider many factors before diagnosing tennis elbow, including how your symptoms developed. If you have a history of rheumatoid arthritis or nerve disease, these symptoms may indicate a different condition. Hoag Orthopedic Institute affiliated elbow doctors are specially trained to treat all types of elbow injuries and will help you uncover the underlying issue to your elbow pain.

During your physical exam, your orthopedic doctor will use a variety of diagnostic tests to pinpoint what exactly is causing your elbow pain. These tests may include asking you to straighten the wrist and fingers on the affected arm against resistance. If you test positive, it can indicate those muscles may be torn or otherwise damaged and your doctor will likely order an ultrasound or an MRI to confirm the diagnosis. Your doctor may also order X-rays to rule out arthritis of the elbow or an electromyography (EMG) to rule out nerve compression. Your elbow doctor will also need to determine if the inflammation of the epicondylitis tendon is affecting the lateral epicondyle (outside) of the elbow or the medial epicondyle (inside). If it is the latter, then you may have golfer’s elbow and not tennis elbow.

Nonsurgical Tennis Elbow Treatment

Our goal at Hoag Orthopedic Institute is to take a conservative, nonsurgical approach whenever possible, and as many as 80 to 95% of patients are successfully treated without surgery. ¹

Nonsurgical treatment may include:

• Rest and modification/avoidance of activities that will aggravate your tennis elbow
• Applying ice to the affected area
• Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for pain and swelling reduction
• Physical therapy to improve functional mobility, flexibility, and decrease pain
• Elbow brace or wrist splint to rest the affected muscles and tendons
• Corticosteroid injections to relieve symptoms
• Sport performance analysis and equipment check

Surgical Tennis Elbow Treatment

If your symptoms do not improve after 6 to 12 months of nonsurgical therapy, it may be time to consider surgery. Two surgical techniques are available for treating tennis elbow — open surgery and elbow arthroscopy. Both procedures can involve removing a small portion of the damaged tendon and then reattaching the healthy portion to the bone. Surgery done with an “open” technique requires a larger incision over the elbow and allows for more options to be taken by your elbow surgeon from removal of a small chip of bone, which can increase blood flow to the area and therefore promote healing and reduce pain. Alternatively, a small portion of the damaged tendon can be released by severing its connection to the bone. This reduces pain, but retains function and minimizes loss of mechanical strength. Finally, the tendon can also be repaired by debridement, or cutting away the unhealthy portion of the tendon and reattaching the healthy portion to the bone.

Arthroscopic elbow surgery is less invasive because two small incisions are made on the medial (inner) and lateral (outer) side of the elbow, leaving minimal scarring, which also enables faster healing. Your elbow surgeon uses an arthroscope to clean out the damaged tendon. Generally speaking, no bone is removed using this procedure, however, some surgeons will scrape the elbow surface to stimulate your body’s own healing process by generating more blood flow to the affected area.

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Source:¹ OrthoInfo - https://orthoinfo.aaos.org/en/diseases--conditions/tennis-elbow-lateral-epicondylitis/