A. LATERAL EPICONDYLITIS, otherwise known as tennis elbow, is one of the most common athletic injuries seen in the family docs office. In truth, it is most common in the part-time or NON-athlete, often in their 40's.
Usually people get a pain on the outside of their forearm (that's outside when you've got your palm facing up to the sky), near the elbow. Most often, this will go away on its own. By the time it gets to the doctor's office, we usually hear complaints of pain down the back of the forearm, into the hand, or rarely, up towards the shoulder. In fact, people relate stories of pain on lifting of almost any item as long as extension of your wrist is involved (palm down to the floor, make a fist, lift your fist FROM THE WRIST, up to the sky. That's wrist extension!) Picking up a telephone can be excruciating!!
Lateral epicondylitis is the result of one of two things. Either repetitive use of the tendons will lead to microfractures in the bone at the site of origin of the tendon, or more likely, small tears appear at or near the origin of the tendon. These partial tears then try to heal on their own. Sometimes they leave a bit of scarring, which can lead to pain, and sometimes they CAN'T heal because you keep using it, which also leads to pain!
As for treatment:
For those with symptoms less than 6 weeks, the above measures are useful. Sometimes a splint worn for several weeks can also help. If that all fails, injections can help, but often require repeating 2 or 3 times. Speak to your family doc about which treatments are most appropriate for your situation.
If you've had symptoms for over a year, you might consider surgery on the advice of a specialist. They can remove scarring or any other local irritations like inflammed cartilege or bursa (pockets of fluid).
As an interesting note of trivia, a study by Coonrad and Hooper in 1973 found that only 5 of 1000 patients with either tennis elbow or golfer's elbow (an analagous injury with flexion of the wrist) actually played tennis or golf!!
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