Tennis elbow
Tennis elbow (epicondylitis radialis humeri) refers to overloading of the tendons on the outside of the elbow. Such an overload can be triggered by playing tennis (backhand), but other activities such as typing on the keyboard, making music or shaking hands a lot can also be triggers. However, manual labourers are most commonly affected.
Affected muscles
The muscles that move the wrist and mainly the fingers are attached to the forearm: the flexors on the inside and the extensors on the outside. The extensors and the extensor extensor come together on the outside of the elbow and attach to the outer bone, the epicondyle, with a common tendon.
Cause
Tennis elbow is an overuse disorder of the tendons. The extensor carpi radialis brevis of the wrist is most commonly affected. Recurrent strain leads to a painful proliferation of connective tissue cells and blood vessels, known as "angiofibroblastic proliferation". Interestingly, however, there is no inflammation.
Symptoms
Tennis elbow causes severe pain. The point of pain is typically just next to the outer bone of the elbow - where the muscles attach. It hurts when you press on it or put pressure on the hand. Lifting and holding objects can also become a problem. In most cases, the function of the wrist remains intact, but the strength and fist closure become weaker. Even if the pain is felt at the elbow, the wrist and fingers are mainly affected by tennis elbow.
Diagnosis
In many cases, questioning is sufficient to obtain a clear result. To rule out other causes of pain, the specialist will take an X-ray. An MRI is also used, especially in persistent cases.
Conservative treatment methods
Although tennis elbow is very common, there is no standardised treatment. And in some cases, treatments are still used that do more harm than good. The most important thing is to stop doing the activity that caused the tennis elbow in the first place, or only do it in a modified way. For tennis players, this means taking a break, trying out a new racquet or changing your technique. You should give your wrist a rest. A cuff that immobilises the joint is useful. Regular, gentle stretching of the muscles can also help. Treatment by a physiotherapist is recommended. In certain cases, cortisone can also be injected. A new type of therapy with autologous blood may also be an option.
Surgical treatment methods
There are a variety of techniques for the surgical treatment of tennis elbow. All of them aim to detach the affected tendon from the bone so that the tendon can scar in the tissue and therefore no longer cause pain.
The operation can be performed minimally invasively using ultrasound through the skin. Arthroscopy is the preferred method so that the entire joint can be assessed and the treatment customised.
Prospects of success
Tennis elbow usually heals quickly if you give it the necessary rest and treat it correctly. However, there are always stubborn cases that require longer treatment. However, surgery is rarely performed.
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PD Dr Andreas L. Oberholzer
FMH specialist in orthopaedics and trauma surgery. Areas of specialisation: Knee, hip and foot surgery.