Although named tennis elbow, this common inflammation of the elbow is just as likely to occur after a weekend of using a hand clipper pruning bushes as it is from playing tennis. Tennis elbow is a painful condition that occurs when the tendons in your elbow are overused and overloaded by repetitive motion of the wrist and arm.
Tennis elbow can be quite painful, making something as simple as lifting your cup of morning coffee a painful exercise. At Elite Plastic Surgery, our team has various treatment methods to help reduce the pain and inflammation. In extreme cases, surgery may be necessary, although this is rare.
What is tennis elbow?
Tennis elbow occurs where the tendons of your forearm muscles attach to a bony bump on the outside of your elbow. The pain is usually located around the elbow, but it can spread down into your forearm and wrist. Clinically known as lateral epicondylitis, tennis elbow really has little to do with tennis. It’s caused by repetitive motions. Plumbers, painters, carpenters, butchers, and really anyone who overdoes the same movement is susceptible to developing tennis elbow. In most cases where the pain is fairly strong, the tendons actually develop small tears due to the overuse.
How is tennis elbow treated?
Tennis elbow usually gets better on its own, providing the person stops the repetitive movements or overuse that led to it in the first place. Over-the-counter pain medications and icing are first steps. From there a series of stretches and movements can slowly help it heal.
But the pain from tennis elbow can endure and it can be quite a bother when performing simple tasks. That’s when patients come see us at Elite Plastic Surgery looking for relief. Here are some of the treatments we use:
If you’ve been doing stretching exercises at home, we may want to take it a step further by placing you with a physical therapist. A physical therapist will take you through and teach you exercises to gradually stretch and strengthen your muscles, especially the muscles of your forearm. We may put you in a forearm strap or brace to reduce stress on the injured tissues.
Some patients find injections of platelet-rich plasma to be helpful. Botox or an irritant (called prolotherapy) can be injected into the painful tendon. Corticosteroids can relieve inflammation in the tendon. Dry needling, where a needle pierces the damaged tendon in many places, can relieve pain.
In from 15 to 25 percent of patients, these conservative measures don’t improve their pain. In the past, surgery was the only other alternative, but a newer treatment, known as percutaneous ultrasound tenotomy is now used. In tenotomy, we can identify the area of diseased tendon with the use of a small handheld ultrasound machine. The affected, painful portion of tendon is typically enlarged and of a darker than normal color. This is where the partial tearing or chronic degeneration is located.
Therapeutic ultrasound is delivered through a special needle into the damaged portion of the tendon. Ultrasonic energy vibrates the needle so swiftly that the damaged tissue liquefies and can be suctioned out.
If your symptoms haven’t improved after 6-12 months or extensive non-surgical treatment, we may feel it is time to surgically remove the damaged tissue. We can usually use arthroscopic methods for these procedures. We make two small cuts, one on the inner (medial) side and one on the outer (lateral) side of the elbow. We use an arthroscope to clean out all of the torn-off tissue. This basically removes a small portion of the tendon.
If you’ve tried the various exercises and stretches you’ve found on YouTube and other online resources for your ongoing tennis elbow, but it’s not getting better. It could be time to see us at Elite Plastic Surgery. While surgery isn’t likely necessary, we can help you get past the inflammation and on the road to being pain free. Call us at (616) 459-1907 to schedule an appointment.