Anatomy of the Elbow
The humerus, located in the upper arm, the radius, located in the middle of the forearm; and the ulna, located at the end of the forearm, comprise the three bones of the elbow joint. Epicondyles are bony bumps located at the lower end of the humerus. These epicondyles are attachment sites for major tendons and muscles that assist arm movement. The lateral epicondyle is the name given to the bump outside the elbow. It facilitates the connection of the tendons and muscles responsible for extending your fingers and wrist.
What exactly is “Tennis Elbow”?
Lateral epicondylitis, most often known as “tennis elbow,” is a disorder that can affect the elbow. Inflammation and micro tears of the tendons that link to the lateral epicondyle can be brought on by overuse, leading to this type of injury.
Tennis elbow is a painful condition that develops when the muscles in the forearm are repeatedly contracted and relaxed. Tennis, painting, hammering, typing, gardening, and playing musical instruments are some of the more prevalent hobbies that put a strain on the hands and wrists that can lead to this condition
Golfer’s elbow and tennis elbow are very similar, with the key difference being that golfer’s elbow affects the inside of the elbow, while tennis elbow affects the outside. The inflammation of the tendons is referred to medically as tendonitis, which both of these conditions share in common.
Tennis Elbow Signs and Symptoms
The following are some of the indications and symptoms that may be associated with tennis elbow:
- Pain on the outside of the elbow that radiates to the forearm and wrist when holding objects
- Pain that begins in the elbow and gets progressively worse over time
- Weak grip
- Painful grip
- Pain that is made worse in the elbow when the wrist is bent back when holding an object
The Factors that Lead to Tennis Elbow
Tennis elbow is typically brought on by repetitive stress on the forearm muscles, but it can also be brought on by a direct blow to the area, such as in the case of a fall, automobile accident, or injury at work.
The condition is named after the sport because of its prevalence among tennis players. Tennis elbow is more likely when a player employs improper technique when striking the ball with a backhand stroke. Other activities that demand repetitive motion of the forearm, such as painting, hammering, typing, raking, weaving, gardening, lifting heavy things, and playing musical instruments, are also major causes of carpal tunnel syndrome.
Medical Diagnosis for Tennis Elbow
To diagnose tennis elbow, your physician will first look at your medical history, conduct a complete physical exam, and then request imaging tests such as X-rays, an MRI, or an electromyogram (EMG) to look for signs of nerve compression.
Tennis Elbow Treatment
- Conservative Treatments for Tennis Elbow
To alleviate the discomfort caused by tennis elbow, your doctor will suggest some non-invasive treatment methods.
- To reduce the time spent using the arm and to refrain from activities that worsen the symptoms.
- The doctor may prescribe splints or braces to reduce the stress on the affected tissues.
- Apply ice packs to the area around the elbow to help minimize any swelling.
- Stay away from activities with a history of aggravating the symptoms and putting additional strain on the tendons.
- Medication that reduces inflammation, such as anti-inflammatory drugs or steroid injections, may be recommended to treat pain and swelling.
- Once your symptoms have improved, your occupational therapist may prescribe strengthening and stretching exercises for your forearm as part of occupational therapy.
- Pulsed ultrasound may treat damaged tendons, promoting increased blood flow and speedy recovery.
- Lateral Epicondyle Release Surgery
If more conservative treatment methods do not resolve the condition and symptoms continue for six to twelve months, your elbow surgeon in Dallas may propose a surgical technique for treating tennis elbow, known as lateral epicondyle release surgery. Surgery is only recommended as a final option, and only one in ten patients require this course of treatment. The success rate of surgery for treating tennis elbow pain ranges between 85 and 95 percent. Your discomfort will be alleviated, and the unhealthy tissue around your outer elbow will be removed after tennis elbow surgery. This will increase the blood flow to the area. Your surgeon will determine whether or not to do your surgery using an endoscopic or more conventional approach. Incisions of up to 2 inches can be made in the elbow region during traditional surgical procedures.
To do the endoscopic surgery, one or two incisions of half an inch are made in the outer elbow and the lateral epicondyle area. An endoscope with a camera is also utilized to observe the internal structures. Every cut made is referred to as a portal. Before the endoscope and other surgical equipment can be introduced via portals, a trocar or a blunt tube must be placed through them.
Your surgeon will be able to observe the elbow joint thanks to the television camera that is attached to the endoscope. The image of the joint will be displayed on a television screen. The surgeon can get a clear view of the joint and evaluate the severity of the issue thanks to the huge image displayed on the television screen.
The second portal is where surgical instruments are inserted into the patient during surgery. To expose the extensor tendon and its connection to the lateral epicondyle, we will use this portal to displace some of the soft tissue in our view. Afterward, your surgeon will cut the tendon to a shorter length or release it before reattaching it to the bone. Both the bone spurs and any scar tissue that may be present will be removed during this procedure. Following the conclusion of the operation, the portals, also known as incisions, are closed using sutures or tape.
In most cases, this procedure is carried out as an outpatient procedure in an operating room, under either regional or general anesthesia, and it is referred to as day surgery.
Compared to the more traditional way of surgically accessing the area around the elbow using large incisions, endoscopic surgery causes significantly less damage to the muscles, ligaments, and tissues. These incisions leave very few scars, typically so subtle that patients do not notice them.
Complications and Risks Associated with Tennis Elbow
As is the case with any major surgical procedure, tennis elbow surgery carries with it the risk of various complications, including the following:
- Allergic reactions to medications
- Blood loss
- Infection
- Nerve damage
- Damage to the radial nerve, which can cause numbness, tingling, burning, or loss of feeling in the back of the hand and forearm
- Wrist weakness with extension
The recurrence of symptoms or the inability to get respite from them
