Monday, March 4, 2013

Tennis Elbow – Not Just For Tennis Players

The most common cause of pain in the elbow is tennis elbow or lateral epicondylitis.  Tennis elbow causes pain on the outside of the elbow and through the forearm.   A weak grip or pain while rotating the wrist (opening a door handle) is also common.   These activities are painful because there is inflammation in the tendon that connects the forearm muscles to a bony landmark on the elbow.  What started the inflammation?  Repetitive activities or sometimes it happens for unknown reasons.

The diagnosis of tennis elbow  is made through a physical exam and an x-ray (to rule out arthritis).  There are many treatment options, including bracing, oral anti-inflammatory medications, physical therapy, and cortisone injections.
In our practice, the first thing we normally recommend is a cortisone injection.  The reason is that it works!  Cortisone is a great anti-inflammatory that begins working within a few days.  The relief can be permanent, or last a few months.  While the benefit of cortisone is clear (decreased or elimination of pain), there are a few risks.  Cortisone will raise a person’s blood sugar for 1-2 weeks, which is important for a diabetic patient to understand.  There is also a very small risk of infection. 

The good news is that 80-95% of patients with tennis elbow get better without needing surgery.  Even if surgery is needed, it is a safe, outpatient procedure with minimal risks.  The recovery is fairly short and you will be placed in a soft elbow splint for one week after surgery.   After surgery you may or may not need physical therapy. 
Random Fact: Less than 5% of patients diagnosed with tennis elbow play tennis. 

Written by: Jennifer Eickhoff FNP-BC, MSN, ATC, LAT

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