What is tennis or golfers elbow?
Tendons attach muscles to bones and are situated all over the body. Tendinopathy is a condition that occurs following repetitive eccentric overload. It can also be part of a degenerative picture in which there are micro-tears. When it affects the common extensor origin it is called tennis elbow or lateral epicondylitis, and the common flexor origins, found on the inside of the elbow, is called golfers elbow or medial epicondylitis. It is important to note that only 10% of patients with tennis elbow actually play tennis.
What are the symptoms of tennis or golfers elbow?
Symptoms are pain and in some cases, pain-related weakness Pain is most commonly felt when that tendon is used for exercise or daily activities. There can be generalised aching following activities and in some patients, this may be felt lower down the arm than the tendon. In some cases, these micro-tears can become more substantial and can even lead to tendon rupture.
How is it diagnosed?
It is diagnosed by taking a careful history and performing a detailed examination. The patient has tenderness over the affected area and pain with special tests. It is important to exclude other potential causes and exclude any significant tears. USS and MRI scans are sued to assess for tears and further delineate the extent of tendinopathy.
How is it treated?
Treatment can begin with symptomatic management with pain killers and physiotherapy to work on strengthening and a range of eccentric exercises. Activity modification is extremely important in treating these tendinopathies. Bracing can be used to offload the tendon. Steroid injections have been shown to prolong symptoms and other measures have been shown to be more beneficial in the long run.
For more prolonged cases failing to respond to these measures, a careful discussion with the patient regarding the options will be undertaken. In some cases, the release of the tendon for symptomatic relief and to promote inflammation and potential healing is required. This can allow patients to return to their normal sporting and occupational activities.
