Tennis elbow and golfer’s elbow (lateral and medial epicondylitis) are common afflictions of middle age adults. While associated with various sports activities, these conditions can result from any repetitive activity including those in the workplace. They are less commonly the result of traumatic injury.
While patients many times believe that their symptoms arise from problems of the elbow bones or the elbow joint itself, tennis and golfer’s elbow actually result from problems at the level of the musculo-tendinous attachment of the forearm muscles to the distal humeral (arm) bone. Microscopic tearing of these tendon attachments many times produce the patient’s symptoms
Many physicians believe that both tennis and golfer’s elbow are attritional afflictions, and part of the normal aging process in adults. In this regard, symptoms can resolve on their own over time. However, symptoms in many cases are pronounced and can restrict and impede activities of daily living.
Numerous treatment options are available. Many patients have loss of motion of the elbow and decreased strength, particularly wrist muscle and grip strength. Exercises and/or physical therapy can dramatically improve symptoms. Because epicondylitis is associated with tendon inflammation, oral and topical non steroidal anti-inflammatory agents may be beneficial. Cortisone injections can dramatically improve symptoms, but should not be used repetitively as they may impede the tendon healing process. Bracing supports the inflamed musculature of the forearm and is useful during activities.
Newer therapies include the injection of platelet rich plasma. The goal is to promote healing of the microscopic tendinous tears. These treatments are still being studied and evaluated. Early results are promising but there are at least 5 different variants of injections that are being utilized and none of these therapies is covered by insurance.
Surgery is rarely necessary but generally quite effective, with a recovery period of 2-3 months.