Tennis Elbow - Lateral epicondylitis
Lateral epicondylitis, more commonly called tennis elbow, is the most common cause of elbow pain and occurs in a large portion of the population between the ages of 40 and 60. This condition is a degeneration of the tendon of a muscle that bends the wrist back. This muscle is called the "extensor carpi radialis brevis" or ECRB. It is not known why this condition occurs in this specific tendon. It is not known why it occurs in certain individuals and not in others. Because many daily activities are performed with the wrist bent back, this condition causes daily discomfort that can interfere with even the smallest activities, such as opening doors. Tennis elbow can usually be diagnosed by with an examination of the elbow. An MRI may also be considered if the diagnosis is uncertain.
In this condition the tendon degenerates and thus tennis elbow is a "tendinosis" not a "tendonitis". As result, rest does not help and the condition can take up to 18 months to resolve. However, tennis elbow always resolves without treatment. Tennis elbow is not dangerous and does not lead to long-term problems within the elbow.
A variety of treatments are available. A counterforce brace can be helpful. This brace is a strap that places pressure directly on the ECRB muscle to offload the tendon. Physical therapy and home exercises can also be very helpful to stretch and strengthen the tendon. Injections can also be helpful. Steroid injections can help to calm the soreness. Dr. Chalmers also has partners that can perform injections of concentrated growth factors to speed the healing process. These injections, called "Platelet-rich plasma" or "PRP", can be helpful for tennis elbow. However, they are not covered by most insurances and are expensive. An ultrasound procedure called Tenex can also incite the tendon to heal.
For patients who have been suffering with tennis elbow for over a year and who have tried bracing, therapy, and injections, surgery can be considered. Tennis elbow surgery is a 30-minute, outpatient procedure in which the disease tendon is removed and the surrounding tendon is repaired with an anchor and sutures. The full recovery after this surgery is 3-6 months. While the procedure is reliable, it is not a guarantee. Up to 30% of patient may still have some pain. Thankfully, the vast majority of patients with tennis elbow never require surgery and Dr. Chalmers only rarely recommends it.
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