Tennis elbow is also known as lateral epicondylitis. It is common in the racket arm of tennis players, but physicians see it more often in non-tennis playing patients. The tendons on the outside, or lateral, part of the elbow become inflamed and tendonitis develops. A golfer’s elbow is essentially the same process, except it develops on the inside, or medial portion of the elbow. The most common cause of the tendonitis is overuse. Repetitive use of the arm may aggravate it. Occasionally, a small injury such as hitting the elbow on the edge of a door may precede the problem, which is then worsened by continued use of the arm.
The main symptom is usually pain with certain motions of the elbow, especially twisting or rotation. Sometimes a constant ache is present which worsens at night. There is usually no associated numbness. The symptoms typically last for several months, and in resistant cases may last for over a year. Treatment initially begins with simple measures. It is helpful after an activity to ice the elbow down for 20 or 30 minutes. Physicians usually first prescribe an anti-inflammatory drug (NSAID) if there are no contraindications such as an ulcer or intestinal problems. These medications include over the counter Ibuprofen and Aleve as well as prescriptions Celebrex, and Naprosyn. Often an elbow counterforce brace is helpful in improving symptoms. Occasionally patients are sent to physical therapy. It typically includes a directed program of light stretching and strengthening. It also may include modalities such as ultrasound or iontophoresis.
If symptoms warrant, a cortisone injection may be performed. This may be helpful in improving one’s pain and returning to more regular activities. The elbow may hurt more the night of the injection, so ice is recommended. Usually, the effect of the cortisone is felt after several days. These injections can be repeated if necessary, but typically no more than three are performed on the same elbow in the same year The majority of patients respond to one or more of the above treatments.
For those who do not improve after an extended course of non operative treatment, typically nine months, surgery may be recommended. There are several outpatient procedures that can be performed. Your doctor will decide what is most appropriate for you A splint or cast may be required for a short period of time. The results of surgery are generally quite good, but some discomfort may persist.