Lateral Epicondylitis

The Problem

Lateral epicondylitis, commonly referred to as “tennis elbow,” is a painful condition that involves tendon degeneration on the outside (lateral) surface of the elbow.  The muscles that extend and stabilize the wrist insert through a tendon on a bony bump (the lateral epicondyle) on the lateral surface of the elbow.  The tendon has a relatively poor blood supply around the site of its attachment to bone.  Decreased blood supply and the fact that this tendon is often subject to repetitive stress and overuse, make it susceptible to degeneration.  Tendon degeneration, rather than inflammation, is thought to be the primary problem underlying lateral epicondylitis.

Symptoms

Main symptoms include pain on the outside of the elbow.  Pain is typically increased with gripping, grasping or lifting activities.  The area is typically tender to the touch and pain is often increased when extending the elbow against resistance.

Treatment

Almost all cases of lateral epicondylitis can be successfully treated without the need for surgery.  Non-surgical, non-invasive treatments include non-steroidal anti-inflammatory drugs, wrist splinting or counterforce bracing (elbow strap or sleeve) and physical therapy.

Steroid injections can be effective in reducing pain from lateral epicondylitis in the short term, but may not be effective in providing long-term relief.  Injections of plasma rich plasma hold promise as a treatment for chronic lateral epicondylitis.

Surgery may be considered if pain becomes debilitating or is non-responsive after several months of non-surgical treatment.  Surgery is performed to remove the degenerated tissue.