Tennis Elbow (Lateral Epicondylitis)

Newer techniques to treat “tennis elbow” injuries are always being refined at the Badia Hand to Shoulder Center (BHSC) in Miami as well as other specialized centers. It’s important that you make an appointment to see Dr. Alejandro Badia for these types of injuries, as they are often misdiagnosed and under treated for a variety of reasons.

Are you experiencing pain on the outside of the elbow?

Lateral epicondylitis is a tendonitis commonly known as “tennis elbow”, although the majority of people with lateral epicondylitis have never played tennis. The condition causes pain on the outside portion of the elbow over a bony prominence named the lateral epicondyle. Pain occurs with activities such as grasping, pushing, pulling, and lifting. As the process progresses, the pain may occur with limited activities or even at rest. Of note, a separate entity termed golfers elbow, or medial epicondylitis, causes pain on the inside of the elbow.

Anatomy

The lateral epicondyle is where the Extensor Carpi Radialis Brevis (ECRB) tendon inserts. This tendon attaches to the muscle that allows your wrist and fingers to extend.

Diagnosis

The diagnosis is usually made based on the history that the patient describes to the healthcare provider, and a physical exam. There will be localized tenderness in the region of the lateral epicondyle. Pain is also often reproduced with the patient extending their wrist under resistance.

X-rays may be done to rule out other causes of elbow pain; however, these are typically normal. Very rarely is MRI (magnetic resonance imaging) needed, but ultrasound imaging can be very helpful in making the diagnosis.

Treatment

Nonsurgical Treatment

Nonsurgical treatment mainly focuses on addressing the symptoms, but do not resolve the cause of the pain. Rest and proper stretching is the first step, combined with anti-inflammatory medications. Stretching is focused on the wrist extensor muscles. First, the extensor muscles are stretched with the elbow held in flexion, and later with the elbow extended. Finally, strengthening exercises are performed, focused on the extensor muscles. The X-Tensor device can be used to help strengthen the extensor muscles.

Surgical Treatment

If symptoms do not respond to nonsurgical treatment, or are severe enough, surgery may be recommended. Surgery for lateral epicondylitis is minimally invasive. After recovery from surgery, the X-Tensor is used to strengthen the extensors.

FAST Procedure by TENEX

The surgical option most often used at Badia Hand to Shoulder Center is the FAST Procedure by TENEX, which is a gentle method for removal of diseased tissue and restoration of natural tendon function. Please keep in mind that now the name has changed to TENEX HEALTH, please refer to this article to learn how TENEX works.

Please call (305)227-4263 to request an appointment with Dr. Alejandro Badia.

Read also: TENEX FAST Procedure Surgery for Lateral Elbow Tendionopathy – Fasciotomy & Surgical Tenotomy