Elbow Epicondylitis

Lateral epicondylitis is commonly referred to as “tennis elbow” and medial epicondylitis is commonly referred to as “golfers elbow”. Pain occurs over the lateral or medial regions of the elbow and is worse with gripping. Tenderness is well localized to a small region near tendon’s attachment to bone. Commonly epicondylitis is gradual in onset and may be related to activity. Tissue changes range from minimal visible tissue change through to mucoid degenerative change through to partial tears of the tendon insertions.

Treatments

  • There is a range of non-­‐surgical treatments. All provide some improvement in some patients. A sports or musculoskeletal physician can direct non-­‐surgical treatments. These include:

    • Time – often symptoms resolve in the end, although this may be more than 1 year later;

    • Activity modification;

    • Eccentric strengthening – physiotherapy may be helpful;

    • Forearm band;

    • Injection treatment – cortisone, blood, and other blood related products; and

    • Shock wave treatment.

Surgery

  • Day surgery, under a short general anaesthetic.

  • Through a short incision over a tender spot.

  • Unhealthy scar type tissue is removed.

  • The bone attachment of the tendon is drilled to allow good cells to come out of the bone and contribute to healing.

  • A padded bandage is applied.

Following Surgery

  • A sling is used for comfort when up over the first 2 or 3 days.

  • 4 days following surgery the padded bandage can be removed.

  • The arm can be used gently as comfort allows.

  • Physiotherapy can be helpful to supervise gradual return of range of movement after the first couple of weeks.

  • Gentle strengthening can be started around 4 – 6 weeks from surgery.

Risks

  • The general risks of surgery (eg. anaesthetic risks, infection, neurological injury) apply but are very uncommon.

Return to Work Guidelines

Sedentary work and driving: 5 – 10 days from surgery.

Light activities: 10 – 20 days from surgery.

Medium gripping: 6 weeks from surgery, depending on progress, and gradually building up.

Although function improves a lot in the first 3 months, improvements in pain symptoms occur over 12 months.