Tennis elbow syndrome – What You Need To Know

Tennis elbow (lateral epicondylitis) syndrome is a medical condition characterised by pain and swelling over the outside of the elbow. Tennis elbow is caused by inflammation of the muscles over the back of the forearm. These muscles attached along the outside of the elbow. Inflammation along these muscles origin thus leads to pain and swelling over the outside of the elbow.

Risk factors for development of tennis elbow syndrome include:

– Work involving excessive typing
– Tennis players with poor swing techniques, heavy rackets or incorrect grip size
– Repetitive heavy lifting or gripping

Symptoms

Symptoms of tennis elbow syndrome:

– Pain along the outside of the elbow
– Pain with gripping activities
– Pain aggravated by actions that involves cocking up the wrist
– Swelling over the outside of the elbow

Even though the symptoms and diagnosis of tennis elbow syndrome may seem apparent, there are other serious conditions that could present with similar symptoms.

Other conditions that could present similarly:

– Compression of cervical nerves (nerves along the neck) can cause pain and tingling along the outside of the elbow and forearm
– Radial nerve impingement
– Triceps tendinitis
– Elbow arthritis

Consult an orthopaedic doctor if you show the above symptoms.

Investigations

Tennis elbow syndrome can be diagnosed clinically without further investigations if the patient’s symptoms and signs are clear. XRays and magnetic resonance imaging (MRI) of the elbow may be performed to confirm the diagnosis.

Treatment

The treatment for tennis elbow should be individualised according to

– patient demographics (age, occupation, sporting activities)
– Severity of symptoms

All patients with tennis elbow syndrome should be given a course of anti-inflammatory medications (oral and/or plasters). Patients should also modify their lifestyle to avoid aggravating activities. They should also wear tennis elbow splint to rest the muscles and allow healing to take place. Patients should also undergo physiotherapy to stretch the forearm muscles. Extra-corporeal shock wave therapy is another form of non-invasive treatment. Shockwave therapy has been shown to stimulate healing and reduce inflammation. If symptoms persist after non-invasive treatment, the next option would be steroid injection. Platelet rich plasma (PRP) would be another option for tennis elbow treatment. Platelet rich plasma is a form of regenerative medicine using patients’ own blood and nutrients for healing.

For patients with severe symptoms that are not relieved by the non-surgical treatments, the next treatment option would be surgical release and debridement of the muscle attachment along the outside of the elbow. This surgery involves releasing the tight muscle attachment and removing some of the degenerative tissues. The surgical release can be performed open or using an endoscope (keyhole surgery). Your orthopaedic surgeon will discuss in detail regarding the pro and con for each option. Open tennis elbow release involves making an incision over outside of the elbow and removing the degenerative tissues. The surgery will be performed under general or regional anaesthesia. The surgery will take about 1 hour. You can be discharge on the same day. Your surgeons will review your condition regularly after surgery to make sure your recovery is on track.