Tennis Elbow Treatment (Lateral Epicondylitis)

• Joint lubrication injection (Viscosupplementation)
• Shockwave therapy
• H&L injection (Cortisone)
• Elbow ligament Repair

Tennis elbow is a painful condition that occurs when the tendons in the elbow region are inflamed and overused. Tendons are tough tissue that helps connect the lower arm muscles to the bone. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

Many people have the notion that tennis elbow is only common among people who play tennis. But that is far from the truth as the condition also affects other athletes and people who participates in leisure or work activities that require repetitive arm, elbow, wrist, and hand movement, especially while tightly gripping something.

Most people in Singapore who have lateral elbow pain likely have this condition. Bear in mind that tennis elbow can happen to anyone regardless of their age, but people above the age of 40 have a higher chance of getting it.

Your elbow joint is a joint made up of three bones: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle. This lateral epicondylitis, involves the muscles and tendons of your forearm. Your forearm tendons, often called extensors, attaches on the lateral epicondyle.

What Causes Tennis Elbow?

As you can likely tell, tennis elbow doesn’t happen overnight. Rather, it develops gradually. People that engage in repetitive gripping activities like swinging have a higher risk of suffering from this condition. The problem with repetitive gripping activities is that they put a serious strain on the tendons. If this continues, the tendon may tear.

Below are some athletic activities that might result in tennis elbow:

• Fencing
• Tennis
• Weightlifting
• Racquet sports
• Knitting

Below are some hobbies that may also cause it:

• Typing
• Carpentry
• Painting
• Raking
• Shopping

Signs and Symptoms of Tennis Elbow

The main symptoms of tennis elbow are excruciating pain and tenderness in the elbow region. The pain is usually intense in the area where the bones are connected to the injured tendons. Note that the pain may radiate to the lower or upper hand.

You are likely going to experience the most pain when you do any of the following-

• Raise your hands
• Grip any object
• Shake hands
• Straighten your wrist
• Carry a load

If you are experiencing any of the above symptoms, it is recommended that you consult an orthopaedic specialist for examination and diagnosis. Bear in mind that there is another condition that is somewhat similar to tennis elbow but occurs on the inside of the elbow and it is known as golfer’s elbow.

Diagnosis and Examination

Tennis elbow is usually diagnosed through physical examination. During physical examination, your physician will ask you to move your wrist, fingers, and elbow in various ways. Pressure may also be applied to the affected area.

Most times, your physical examination and medical history will provide the information your physician needs to make a diagnosis.

Treatment for Tennis Elbow

Here are some simple ways in which you can speed up the healing process:

• Elbow Strap

Using an elbow strap will help reduce the strain on your injured tendons.

• Exercise & Physiotherapy

Stretching exercises can help increase the flexibility of your elbow and reduce stiffness and pain. You may have to do these physiotherapy exercises 3 to 5 times daily to get the most out of them.

• Taking Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and Medications

NSAIDs medications like aspirin, ibuprofen, and naproxen can help reduce pain and swellings. Use these drugs sparingly and as directed by your physician.

• Physical Therapy

A physical therapist can teach you effective exercises that will help strengthen your muscles. They may also treat the condition with heat pads and ultrasound.

• Injection

Your doctor may suggest a joint lubrication injection (viscosupplementation), H&L injection (cortisone) or platelet rich plasma injection to treat the condition.

• Radial Shockwave Therapy

This procedure involves using a machine to generate radial shockwaves to stimulate the tissue and provide a healing response. You may require several weekly sessions to achieve full recovery.

Home and lifestyle remedies

Below are some self-care measures your doctor may recommend if your condition isn’t too severe:

• Ice

Place ice or a pack of ice on the affected area for 15 minutes 3 to 4 times daily.

• Rest

Don’t engage in strenuous activities that can intensify your elbow pain. Try to get 7 to 8 hours of sleep each night.

• Pain Relievers 

If suggested by your doctor, you can take pain relievers such as naproxen and Ibuprofen.

When is Surgery Required?

If your symptoms persist after 6 to 12 months of non-surgical treatments, surgery may be recommended to treat the affected tissue.

It is advised to seek professional advice from Dr Siow to provide appropriate treatment and rehabilitation program for you.