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Tennis Elbow (Lateral Epicondylitis)

Tennis elbow (lateral epicondylitis) is one of the most commonly seen problems in the elbow.  It is a chronic condition causing pain and limited function at the elbow.  It is caused by repetitive forearm flexion and extension frequently seen with activities such as tennis, pitching, golf or even turning a screwdriver!  


The elbow joint is made up of three bones: one bone in your arm (humerus) and two forearm bones (radius and ulna).  At the end of the humerus there are two prominent ends, one on the inside (medial epicondyle) and one on the outside (lateral epicondyle) of the elbow.  On the lateral epicondyle, a large group of muscles originate called the extensor muscles.  These muscles are responsible for wrist and finger extension.  Lateral epicondylitis is caused by repetitive microtrauma to the extensor muscles at the origin.  This repetitive trauma leads to inflammation of the muscles at the lateral epicondyle.
If you have lateral epicondylitis, you may experience an aching pain in the region of the lateral epicondyle during and after activity.  The pain may gradually worsen and eventually result in weakness in the hand and wrist.


This particular injury can be properly diagnosed with clinical evaluation and musculoskeletal ultrasound performed in the office.  An ultrasound of the affected area can show both inflammation and/or scar tissue within the tendons.


Treatment of lateral epicondylitis is generally conservative initially consisting of RICE (Rest, Ice, Compression, Elevation), anti-inflammatories and rehabilitation.  Additionally, a brace may be recommended to disperse the stress along the muscles and reduce symptoms.  If conservative management fails, other options include steroid injections, PRP injections or surgery.  These injections can be performed with ultrasound guidance ensuring the proper area is treated.  Your doctor can discuss these different options with you and help choose what is right for you.


After lateral epicondylitis surgery, performing rehabilitative exercises may gradually return full flexibility and stability to your elbow, wrist and hand.  Building strength in your forearm muscles to support the repaired muscles is the primary goal of rehabilitation.  Additionally, ASTYM may be utilized by the rehabilitation specialist to assist with the break-up of scar tissue and stimulating the regenerative healing process.  It is important not to return to full activity too soon to prevent reinjury.