Lateral Epicondylitis is the medical term for tennis elbow. It is a painful condition affecting the tendons on the lateral (outside) of the elbow joint where they attach to the bony prominence known as the lateral epicondyle.
The condition affects 1-3% of the population. It usually occurs most commonly in the 30-50 years age group.
The condition is related to overuse and repetitive overload (e.g.: tennis players or manual labourers) of one of the tendons originating from the lateral epicondyle of the elbow – Extensor Carpi Radialis Brevis.
This wear and tear leads to microscopic tears and inflammation which can progress to bigger tears.
Signs and Symptoms
Diagnosis is based on patient symptoms, examination findings and scans.
Pain is located over the bony prominence on the outside of the elbow. The pain is worse with repetitive use especially with extension of the wrist and gripping objects.
There may be weakness of grip.
Ultrasound and MRI
These may show degenerative changes in the tendon as it inserts into the bone. It may also show tears. MRI is more sensitive than Ultrasound.
More than 90% of patients will have success within 1 year with non-surgical treatment.
Non-surgical treatment includes:
Activity Modification and Rest
Avoiding activities which cause pain. This may involve stopping particular sports, changing jobs or changing roles at work.
Non-Steroidal Anti-inflammatory Medications
This includes medications such as Nurofen and Voltaren which have an ant inflammatory action and can alleviate the pain. Anti-inflammatory Gels may also be applied to the area.
This involves stretching and strengthening of the affected tendon and muscle.
This brace is worn just below the elbow over the affected forearm muscle. It helps to relieve the tension/force over the tendon.
This delivers strong local anti-inflammatory (corticosteroid) medication to the area. A Maximum of three injections to the area in a lifetime is recommended. Injections can be used if other measures have been unsuccessful for 3-6 months.
Platelet Rich Plasma (PRP) Injection
This involves withdrawing blood, concentrating it so that its rich in healing cells and injecting it to the site of degenerative tendon to promote healing.