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Tennis Elbow

What is tennis elbow?

This is a painful condition involving an area where several muscles attach to bone on the outer side of the elbow. The bony attachment is called the lateral epicondyle, hence the medical name for the condition. The area of attachment becomes inflamed, usually after overuse, and a vicious cycle of poor healing and degeneration occurs resulting in prolonged symptoms.

What causes tennis elbow?

The involved muscles work to extend the wrist (as in the picture). Tennis elbow is usually caused by repetitive overuse of these muscles and occasionally by a direct injury. Racquet sports can be implicated but routine daily tasks, involving gripping and moving the wrist, are more commonly cited by patients.

What are the symptoms of tennis elbow?

Tennis elbow occurs most frequently between the ages of 30-50 years in men and women. Pain with certain activities is noted. This pain often is felt from the outer side of the elbow (circled in picture) down into the forearm, along the course of the affected muscles. The tip of the lateral epicondyle becomes tender to touch. In severe cases elbow movements, particularly straightening, become painful. Other conditions may mimic tennis elbow and must be carefully excluded.

What is the treatment of tennis elbow?

Fortunately most patients with this condition do not require surgery.

With rest and activity modification alone most cases settle over a period of a few months to several years. Anti-inflammatory medication can be helpful. Physiotherapy and a tennis elbow clasp can relieve the symptoms somewhat. A tennis elbow (or epicondylitis) clasp is a padded strap worn just below the elbow. It squeezes the muscle before it attaches to the lateral epicondyle so reducing the muscle pull on the bone during activity.

A local anaesthetic and steroid injection may relieve a severe episode by damping down inflammation in the muscle attachment.

Surgery at The Horder Centre is possible, but it is reserved for severe, resistant cases and involves cutting out the damaged area of muscle attachment. This is only successful at relieving symptoms in about 70% of cases.

Information provided courtesy of our Consultant Orthopaedic Hand Surgeon, Mrs Lisa Leonard.

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