Tennis Elbow – Medical Update

12-7-2013 8-36-54 AMA frequent and frustrating complaint in the orthopedic surgeon’s office is that of lateral elbow pain. This pain is often diagnosed as Tennis Elbow or Lateral Epicondylitis. It can be stubborn and difficult to treat.

Usually, patients have already attempted conservative treatment with anti-inflammatory medications and elbow braces or straps. Often these treatments are met with little success.

Lateral Epicondylitis was named Tennis Elbow because of the relationship of the motion required to hit the tennis ball with the “backhand.” This causes excessive force through the attachment of the muscles that extend the wrist, which in turn causes injury to the lateral elbow muscle attachments, and thus the problem.

Patients complain of point tenderness over the lateral elbow, morning stiffness and the pain is made worse with extension of the wrist. The pain can be a radiating pain into the forearm, and weakness and pain with gripping.

12-7-2013 8-37-10 AMIt is considered an overuse injury and is made worse with deconditioning and repetitive micro-trauma. Elbow straps probably play a more important role in prevention than treatment of flare ups. Cock–up wrist splints help decrease the offending motion of wrist extension and can be helpful.

Although it is by nature not inflammatory on microscopic evaluation, anti-inflammatory injections with steroids are often very helpful. The most important treatment is to stop the offending trauma and allow the area to heal. Often times MRI scans will reveal areas of micro tears within the tendon attachment at the elbow. In a small percentage of cases, surgical debridement may be indicated. A new procedure called the Topaz procedure is a minimally invasive method of treatment for Tennis Elbow. It uses a cauterization tool about the size of a ballpoint pen, to generate insult through cautery, which ultimately results in launching the body’s healing potential that will result in healing of the underlying problem.

Physical therapy is another effective modality for treatment. Exercises such as “Tyler Twist” help to eliminate pain and increase strength to the elbow. Chiropractic manipulation and topical medication also have shown improvements.
Dr. Patrick Boyett
Dr. Bill Lawrence
OrthoSports Athens, LLC
15243 Greenfield Drive
Athens, AL 35613
By: Dr. Patrick Boyett

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