Tennis Elbow (Tendinitis)
You don't have to be a tennis player or golfer to develop a painful case of elbow tendinitis, also known as "tennis elbow" or the less common "golfer's elbow."
Elbow tendinitis is a type of inflammation that particularly strikes people who do a lot of activities that use the thumbs and two forefingers to grip. Knitters, musicians, and many other people who use their hands extensively can get the condition.
Yale Medicine Orthopedics & Rehabilitation provides advanced treatments and techniques for elbow tendinitis that are not widely available elsewhere.
What are the symptoms of elbow tendonitis?
Symptoms include pain with a gradual onset, sometimes radiating down the arm, along with swelling and tenderness in the forearm and elbow.
What causes elbow tendinitis?
The problem usually starts with a microscopic tear, which leads to inflammation. Inflammation is supposed to be healing, but when it doesn’t stop, it can lead to a problem like tendinitis.
There are two types of tendinitis. When the tendinitis affects the outside of the elbow, as is typically the case with tennis players, the medical diagnosis is lateral epicondylitis. When the problem is on the inside of the elbow, as happens more often with golfers, it’s called medial epicondylitis.
How is elbow tendinitis diagnosed?
A clinical exam is used to diagnose elbow tendinitis. Specifically, doctors look for tenderness in very specific sites on the inside or outside of the elbow, made worse when the tendons are contracted. The problem may show up with magnetic resonance imaging (MRI), but not on an X-ray.
How is elbow tendinitis treated?
Nonsurgical treatments for elbow tendinitis solve the problem for about 90 percent of patients with the condition. The different levels of treatment, in order of their use, are:
- Nonsteroidal anti-inflammatories, taken orally, are usually prescribed, along with rest, an elbow brace for support and physical therapy.
- Steroids, delivered directly to the site of the inflammation via phonophoresis (an ultrasound delivery mechanism) or iontophoresis (an electrical delivery mechanism). If those fail to bring relief, cortisone shots may be helpful.
- Platelet-rich plasma, a biologic therapy using plasma from the patient’s blood that has been enriched with platelets to speed healing, can be effective.
Surgery is considered a last-resort treatment. Of the 10 percent of patients who are not helped by conservative treatment, 90 percent will find relief from surgery.
What type of surgical procedure helps elbow tendinitis?
Arthroscopic surgery can clean out the inflammation, a technique that requires special expertise. The procedure requires several small incisions. It takes only 20 minutes and is performed on an outpatient basis. After surgery, the patient wears a sling for about two weeks and spends six weeks avoiding heavy lifting and doing physical therapy.
For appropriate patients, the arthroscopic approach has several advantages over a traditional open procedure, including less bleeding, lower risk of complications and faster healing. Recovery can vary from days to several weeks, but most patients don’t find the procedure or healing period to be very painful.
What makes Yale Medicine’s approach to elbow tendinitis unique?
Yale Medicine has a specialized shoulder and elbow service, with the skill set to deal with any type of problem. Yale Medicine’s involvement in clinical research, including specific studies on tennis elbow, provides a deeper level of understanding that is of great benefit to Yale Medicine patients.