Tennis elbow is a very common cause of elbow pain. It is a very silly name because most tennis players do not get tennis elbow, and most patients I see with tennis elbow do not play tennis! :-)
The pain of tennis elbow is on the outer or lateral side of your elbow. The pain of tennis elbow is worsened by lifting with your palm facing down. If the pain is severe you will even have pain trying to lift up a coffee cup. Numbness and tingling is not common with tennis elbow, but radiation of the pain down into the forearm can happen in many.
The formal name of tennis elbow is lateral epicondylitis. Say that three times :-) . The -itis implies inflammation, but we now know that there is no evidence of inflammation when we look at pathology specimens. So — tennis elbow is another form of tendinopathy. That means that your tendon is starting to degenerate. Tendinopathy (tendinosis) is very common in tendons around the shoulder, knee, ankle and elbow.
Most patients with tennis elbow will respond to using a compression sleeve, heat and stretching exercises. Certain natural anti-inflammatories may help too. A Flex Bar can be very effective and has help many of you avoid injections and surgery.
Cortisone injections should be avoided because they can potentially worsen the degeneration or tendinopathy. That means you might feel great for a few months, but the pain might become worse when it recurs. Physical therapy, with use of a flex bar can be effective in most cases. When the pain persists despite activity modification, a flex bar, and PT — some physicians might advocate for a PRP injection. Surgery for tennis elbow is rarely necessary … but it is useful and successful in most if your pain fails to improve with anything else.
Elin says
You are very kind to answer comments. I am a surgeon myself and suffering from 6 months of tennis elbow. I have tried rest/ice/banding/ physio/ acupuncture/ graston technique/ flexbar and now shock therapy (x3) with minimal improvement. The next treatment planned is steroid injection and then PRP if unsuccessful. I am worried about the rare risks of steroid injection- tendon rupture and extensor weakness. Do you have any thoughts? I am very discouraged as I have seen so little improvement.
Howard J. Luks, MD says
HI Elin ..
Sometimes you need to get another pair of eyeballs on the situation to confirm that the diagnosis is accurate. That being said, once the diagnosis is confirmed ( a small amount of lidocaine will do that) then you can consider other treatments. I would forgo consideration of a steroid injection and instead consider PRP or Bone marrow injections. After that the Tenex procedure has been shown to be very effective in the right hands.