Tennis Elbow and Golfer's Elbow (lateral and medial epicondylitis)

Epicondylitis is an irritation or inflammation of the tendons around the elbow joint. 

Tennis Elbow (lateral epicondylitis) is a painful condition on and around the bony prominence (epicondyle) on the outside (lateral side) of the elbow. Pain may radiate down the arm. Gripping or extending the wrist may intensify the pain. 

Golfer's Elbow (medial epicondylitis) is a similar condition, though the pain focus is the knobby bump on the inside of the elbow closest to the body (the medial side). 

Both tennis elbow and golfer's elbow typically result from repetitive arm movement and more often occur as a result of everyday activity rather than golfing or tennis playing. Over-using the muscles in the arm can lead to tiny tears (micro tears) in the tendons that attach the muscles in the forearms to the epicondyles. 

If the activity is continued without allowing the tears to heal, the tendons can become inflamed and very painful. 

While this condition can be caused by excessive use of the arm in long sessions practicing your golf swing or tennis stroke, it is more often the result of other everyday activities including painting, raking, pitching, rowing, hammering and using a screwdriver.

Symptoms of Lateral or Medial Epicondylitis:

  • Pain and discomfort when moving the elbow (and sometimes at rest) - to the outside of the elbow if tennis elbow and the inside of the elbow if golfer's elbow.
  • Pain radiating down the forearm and possibly weakness in the wrist.

Causes of Lateral or Medial Epicondylitis:

  • Overuse, repetitive activity engaging the elbow joint.
  • Lifting a heavy object

Diagnosis:

In order to diagnose epicondylitis, a thorough examination is performed, including X-rays and possibly an electromyogram (EMG) to test nerve and muscle function.

Treatment Options:

  • Rest, allowing the micro- tears to heal.
  • If sports-related, technique and equipment should be examined.
  • Breaks during work or play, avoiding activities or movements which cause pain (heavy lifting, pushing, or pulling should be limited).
  • Ice Pack to affected area (not directly on the skin) for approximately 20 minutes three times a day, to decrease inflammation and pain.
  • Anti-inflammatory medication, an oral medication to help relieve inflammation and pain.
  • Steroid injection, a locally acting injection to help decrease inflammation and pain.
  • Counterforce brace (elbow cuff) worn during the day to help support the inflamed tendon.
  • Cock-up wrist splint (wrist brace) worn during the night to help rest the tendon.
  • Physical Therapy (three times a week for approximately six weeks) initially to decrease pain and inflammation and maintain muscle strength, and ongoing to increase strength and endurance.

If symptoms persist despite conservative treatment, surgery may be recommended. 

Dr. Rosen now offers Platelet-Rich Plasma (PRP) injections for the treatment of medial and lateral epicondylitis. PRP stimulates a more rapid healing of tendon, ligament, muscle and bone. He is also among the hand specialists in Houston who offers the less invasive OssaTron ESW (extracorporeal shockwave) therapy to treat chronic tennis elbow.

 

© Copyright 2015 Dr. Allan Rosen MD