What is Tennis Elbow (Lateral Epicondylitis)?
Tennis elbow is an overuse syndrome related to excessive wrist extension. It is also referred to as lateral epicondylitis. Microscopy reveals an excess of fibroblasts and blood vessels consistent with neovessels or angiogenesis. Associated tendons are hypovascular proximal to tendon insertion, which may predispose the tendon to hypoxic tendon degeneration.
Characteristics and Clinical Presentation of Tennis Elbow
Patients may report insidious onset, but often relate a history of overuse without specific trauma. Patients may complain of pain that worsens with activity and improves with rest. The pain may also radiate down the posterior aspect of the forearm.
Pain can vary from being mild or it can be such severe pain that simple activities like picking up and holding a coffee cup will act as a trigger for the pain.
Causes of Tennis Elbow (Lateral Epicondylitis)
Tennis elbow occurs due to overuse of the forearm muscles and associated tendons. Repetitive movements, such as gripping a racket, has the possibility of straining the muscle and placing too much strain on the tendons.
Other common causes of tennis elbow include:
- Improper training.
- Improper technique.
- Improper equipment.
Getting a Diagnosis for Tennis Elbow
Dr. Mark Pruzansky and Dr. Jason Pruzansky commonly treat patients with tennis elbow. To best diagnose tennis elbow, they will perform an examination to narrow down possible differential diagnoses.
- Pain is increased with radially deviated and pronated and the elbow extended.
- Pain may also increase with the elbow extended and the wrist maximally pronated.
- Increased pain is noted with resisted supination, gripping, and handshaking.
Nonsurgical Treatment Options for Tennis Elbow
Many patients have success with nonsurgical treatment. Topical NSAIDS such as diclofenac may offer some short-term relief and corticosteroid injection can provide pain relief at 6 weeks.
Counterforce braces can reduce the tension forces on the wrist extensor tendons.
Additionally, strength training, exercise, and stretching have been shown to decrease pain in patients with lateral epicondylitis.
Surgical Treatment Options for Tennis Elbow
Through arthroscopic surgery, tennis elbow can also be repaired using miniature instruments and small incisions. For most, this is a same-day or outpatient procedure. It is important that each case is evaluated individually, because some patients may have multiple relapses or lack progression through therapy. These patients may benefit from surgery after a shorter trial of conservative care.
Complete tendon rupture is the most common complication. This injury often causes a palpable defect in the extensors, which results in weakness on attempted wrist extension. Frequently, the treatment of this complication is a surgical repair.
Prevention of Tennis Elbow
Stiffer racquets or looser strung racquets may reduce the stress on the forearm. If you use an oversized racquet, changing to a smaller head may keep symptoms from recurring. The best treatment option for tennis elbow is to never require treatment in the first place.
You can try to reduce your risk for tennis elbow with:
- Attention to proper form and technique.
- Proper equipment.
- Improved conditioning.
- Improved core strength.
Prognosis for Tennis Elbow
Although most patients with lateral epicondylitis tend to improve in 9-18 months, they need to be made aware that successful treatment may be a prolonged course. Refractory cases may need surgical intervention.
If You Believe You Have Tennis Elbow (Lateral Epicondylitis), Contact HandSport Surgery Institute
Please contact us as soon as possible to schedule an appointment with our talented team. People experiencing tennis elbow should be evaluated to try and reduce the risk of further injury and mobility issues.
If you have been injured, it’s important to be evaluated by a highly skilled professional. Call Dr. Mark Pruzansky and Dr. Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.