Lateral elbow tendinopathy
Tennis elbow is a condition that causes pain over the outer aspect of the elbow. The muscles that extend the wrist and fingers all originate from the lateral epicondyle, the bony prominence felt on the outer aspect of your elbow. The tendons of these muscles can develop wear and tear, particularly with repetitive use, that causes pain on activities and a reduced grip strength. Continued problems occur due to the tendons not fully recovering.
What are the causes?
Tennis elbow is not due to inflamed tendons but damaged tendons. It commonly affects people in their 40’s and 50’s and will usually start after a period of sustained use of the elbow. Amateur tennis players have an increased chance of developing it, hence the name. It is also commonly seen in people with a manual job, such as plumbers or cleaners.
What are the symptoms?
There is usually tenderness that can be felt just below the lateral epicondyle. Increased pain can be experienced when trying to lift a heavy object or gripping things with the hand. There is usually a constant dull ache felt around the elbow which is a nuisance as opposed to severely disabling but as symptoms persist becomes more aggravating.
How is it diagnosed?
Your surgeon can usually make the diagnosis by asking about the symptoms you have and examining your elbow. There is usually no need for any special investigations although an MRI or ultrasound can be used if the diagnosis is in doubt
How is it treated?
Simple painkillers, rest, physiotherapy and a tennis elbow strap are usually very effective at treating symptoms. Steroid injections have been used in the past but evidence shows that, while they work in the short term, the symptoms come back and are harder to treat. Therefore, steroid injections are best avoided.
Injections of hyaluronic acid have been shown to be effective. Surgery in the form of a tennis elbow release is also effective and can be performed if symptoms persist.