Why Does Tennis Elbow (Lateral Epicondylitis) Occur? How is it Treated?

Why Does Tennis Elbow (Lateral Epicondylitis) Occur? How is it Treated?

28 March 2019 10:47

Tennis elbow is the name given to the disease with pain on the outer side of the elbow joint. It is usually observed between the ages of 30-50. Tendons (beams) are the tissues that allow the muscles to attach to the bones. The beams adherent to the side of the elbow are actually the beams that provide the movement of the wrist joint. The wear and tear of these adherent beams (tendons) and sometimes the formation of tears are the main source of pain. The pain is therefore caused by wrist movements, especially when lifting weights and grasping objects (teapots, etc.).

What Are the Causes of Tennis Elbow?

Excessively hitting the outer side of the elbow or an abruptly reversed movement may cause swelling (edema) on the tendon and subsequent wear and tear. The reason is often the strain of tendons in daily work with frequent repetitions.

These can be heavy housework, computer use, sports or work-related movements. These movements are usually wrist movements made with the grip of an object (keyboard use, playing tennis, plumbing, filling tea, chopping with knife).

Results: The most important finding is the pain that does not decrease day by day and increases on the contrary. The extreme pain caused by the hand grasping or lifting an object in the bone protrusion (lateral epicondyle) and around which is pronounced on the side of the elbow is typical. Sometimes the pain can spread to the arm or shoulder joint.

Treatment of Tennis Elbow

Treatment: The success is achieved mostly by non-surgical treatment methods. The treatment should be planned in stages.

1) First, strains and movements considered to cause pain in daily life should be terminated. Pain relief (NSAI), splint use, stretching-strengthening exercises are among the applicable treatment methods. The success of these treatment modalities is generally high.

2) Corticosteroid (cortisone) needle: Cortisone is a potent inflammation-suppressing drug. In case of failure of the above-mentioned treatments or as the first treatment, it may be applied to the painful area with the help of an injector. In total, no more than 3 injections should be performed. In some publications, it is stated that the bone protrusion is punctured only with the tip of the needle and the same results are obtained.

3) ESWL (shockwave) treatment: With ultrasonic sound waves, increased blood supply at the adhesion point of the beam to the bone, acceleration of healing and pain relief are provided. Success can be achieved in 50-60% of patients.

4)PRP (Protein Rich Plasma) application: It can be used when a resistance to other treatment methods takes place or in the first treatment of patients who apply with long-term pain.

5) Surgical treatment: It is rarely required. It can be applied in the event that the pain persists for more than 6 months even though all non-surgical treatment have been tried and obstructs the performing of daily works. The surgery involves mainly the removal and sometimes suturing of worn and diseased beams. Surgical intervention can be performed by classical or arthroscopic method according to the structure of the disease. Complete recovery after surgery includes an average of 4-6 months, including rehabilitation.

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Orthopedics and Traumatology Prof. Dr. Hakan Gündeş
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