What is tennis elbow?
Sometimes called lateral epicondylitis, this is an overuse injury that is one of the commonest causes of pain in the elbow. It causes pain over the outer side of the elbow especially when objects are gripped, when the wrist is cocked back and when heavy objects are lifted. Sometimes the pain also radiates along the forearm.
It occurs when the muscle that attaches to the outer elbow (lateral epicondyle) becomes overworked. Although its name comes from the fact that it can be seen in tennis players who have poor back hand stroke techniques, it is also commonly seen in people who perform repetitive wrist and elbow movements of a similar type, such as other racket sports players, manual workers and people who use computers for long periods.
How is it diagnosed?
Diagnosis by a specialist is usually straightforward and further tests are usually not necessary. X-rays may be performed to exclude other causes for tennis elbow pain. In some cases that are not as clear cut, an ultrasound scan may be performed to confirm the diagnosis.
How is Tennis Elbow treated?
Most cases will respond to simple measures. The first Treatment for Tennis Elbow is to correct any provoking factors. Changing the way objects are lifted orswing technique in racket sports can help reduce the pain. Simple anti-inflammatory tablets and painkillers can also help. Appropriate stretches and muscle strengthening exercises, usually under the guidance of a physiotherapist can also be considered as a Tennis Elbow Treatment. Avoiding repetitive movements and correct warming-up and stretching techniques can also help.A tennis elbow strap is also effective in reducing pain, but some find this difficult to wear for long periods.
What is the role of Shock Wave Therapy?
Sometimes the condition does not respond to these simple measures and the pain becomes longstanding (chronic). In these cases other tennis elbow treatments are considered. A steroid injection may be suggested, but the evidence for this being of benefit in tennis elbow is not clear. We do not recommend in the first instance as it does not usually result in a permanent cure by creating a healing response. We prefer to use Shockwave Treatment for Tennis Elbow as the next line of treatment and have had excellent results with this needle-free, outpatient procedure in 65-70% of patients. This treatment induces a healing response and so is more likely to result in the condition being cured.
We have also used platelet-rich plasma (PRP) injections in some very resistant cases. This works by injecting healing cells derived from the affected persons own blood into the affected area.
As a last resort, in patients with severe symptoms that have not responded to all other tennis elbow treatment, surgery is considered. This involves detaching the tendons from the outer part of the elbow. Unfortunately even this can be unsuccessful in about a third of patients.
We have found shock wave therapy to be 70-80% successful for the treatment of tennis elbow pain in a wide range of patients; some of whom have had the condition for a number of years