Tennis Elbow

What is tennis elbow?

Sometimes called lateral epicondylitis, this is an overuse injury that is one of the commonest causes of pain in the elbow. It causes pain over the outer side of the elbow especially when objects are gripped, when the wrist is cocked back and when heavy objects are lifted. Sometimes the pain also radiates along the forearm.

It occurs when the muscle that attaches to the outer elbow (lateral epicondyle) becomes overworked. Although its name comes from the fact that it can be seen in tennis players who have poor back hand stroke techniques, it is also commonly seen in people who perform repetitive wrist and elbow movements of a similar type, such as other racket sports players, manual workers and people who use computers for long periods.

How is it diagnosed?

Diagnosis by a specialist is usually straightforward and further tests are usually not necessary. X-rays may be performed to exclude other causes for tennis elbow pain. In some cases that are not as clear cut, an ultrasound scan may be performed to confirm the diagnosis.

How is Tennis Elbow treated?

Most cases will respond to simple measures. The first line treatment for Tennis Elbow is to correct any provoking factors. Changing the way objects are lifted or swing technique in racket sports can help reduce the pain. In addition, simple anti-inflammatory tablets and painkillers can also help. Appropriate stretches and muscle strengthening exercises, usually under the guidance of a physiotherapist are also important. Avoiding repetitive movements and correct warming-up and stretching techniques can also help to prevent  tennis elbow. A tennis elbow strap is also effective in reducing pain, but some find this difficult to wear for long periods.

What if these don’t help?

Sometimes the condition does not respond to these simple measures and the pain becomes longstanding (chronic). In these cases other tennis elbow treatments are considered. A steroid injection may be suggested, but the evidence for this being of lasting benefit in tennis elbow is poor. We prefer to use Shockwave Treatment for Tennis Elbow as the next line of treatment and have had excellent results with this needle-free, outpatient procedure in 65-70% of patients. This treatment induces a healing response that has a higher chance of curing the condition.

We have also used platelet-rich plasma (PRP) injections in some resistant cases. This works by injecting healing cells derived from the affected persons own blood into the affected area.

As a last resort, in patients with severe symptoms that have not responded to all other tennis elbow treatment, mini-incision day surgery is considered. Our technique does not involve a large scar or weeks of pain and limitation as we use modern technology and techniques.

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