Tennis Elbow

WHAT YOU SHOULD KNOW:

  • Tennis elbow, also called lateral epicondylitis, is a condition that causes pain in your elbow area. The elbow is a joint where your upper arm bone (humerus) meets your two lower arm bones (radius and ulna). The bones in your elbow joint are held together with ligaments. The muscles that surround your elbow joint are connected to bone by cords of tissue called tendons. There also are blood vessels and nerves found in and near your elbow joint. Caregivers believe tennis elbow is caused by overusing the muscles in your forearm. Fast repeated arm movements can lead to inflammation (swelling) and small tears in your tendon. Overuse of the muscles leading to tennis elbow is common in tennis players and manual labor workers.
    Anatomy of the Arm


  • The pain from tennis elbow is often felt in the area of your lateral epicondyle. The lateral epicondyle is the bony end of your humerus that you can feel on the outer side of your elbow. The tendon that connects your muscles to your lateral epicondyle is the extensor tendon. When you have tennis elbow, you may not be able to move your elbow or arm like you normally do. You may have pain that worsens when moving your hand or wrist, and problems holding or lifting. You may need x-rays, magnetic resonance imaging (MRI), and an ultrasound to diagnose your tennis elbow. Treatments include rest, medicines, elbow supports, physical therapy, and surgery. Treatment may allow you to return to the activities you enjoy, such as sports.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may have an allergic response to the medicines used to treat your tennis elbow. Steroid shots may cause pain, changes in your skin color, and fat loss in the area of the shot. Steroid shots may also weaken your tendon and increase the risk for tendon rupture. Botox shots may cause finger numbness and weakness. Surgery may cause you to have pain, swelling, and bruising. Surgery may also cause nerve damage leading to numbness (loss of feeling) in your elbow or forearm. New bone may form in abnormal areas around your elbow as the area is healing. Even after treatment, you may still have pain and weakness in your elbow, wrist, or hand. With treatment your symptoms may go away and then return again after a period of time.

  • Without treatment your symptoms, such as pain may not go away or get worse. You may have problems using your arm or hand. You may not be able to grab, squeeze, or lift items with your injured hand and arm. It may be hard for you to do your usual daily activities. Talk to your caregiver if you have questions or concerns about your condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

  • Injection therapy:

    • Steroid injections: Steroid injections (shots) may be given in your injured elbow to help decrease pain and swelling.

    • Botulinum toxin type A: Botulinum toxin type A (Botox) may be given as a shot into your elbow to help decrease your pain. Botox shots also may help your muscles and tendons rest and heal.

  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Treatment options:

  • Elbow supports: An arm strap, brace, or splint may be put on your elbow to limit your arm movement. Braces and splints work to help decrease pain, and prevent further damage to your tendon.

  • Physical therapy: Your caregiver may have you go to physical therapy. A physical therapist will help you with exercises to stretch and strengthen your tendon. These exercises may also help to decrease your pain. You will need to start slowly and increase your activity as you get stronger. Physical therapy may help you return to your usual activities faster. During physical therapy, you may also have the following:

    • Massage: A caregiver may massage the deep tissues in your elbow and forearm to improve movement and healing.

    • Ultrasound: During an ultrasound, a small plastic or metal tool will be moved around your elbow where you have pain. The tool uses heat to reach your deep tissues and decrease your pain. The heat may also decrease any swelling and help heal your tissues.

  • Shock wave therapy: During shock wave therapy, sound waves are directed into the tissues around your elbow. This therapy may help to decrease your pain and improve healing.

  • Surgery: You may need surgery if your symptoms do not improve with other treatments. Surgery may be done to release (cut) the extensor tendon from the lateral epicondyle. Your caregiver may remove any damaged tendon tissue before reattaching the tendon to nearby tissue or bone. Your caregiver may also do surgery to only remove damaged tissue without cutting the tendon away from the bone. Ask your caregiver for more information about surgery to treat your tennis elbow.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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