Tennis elbow is the common name used for the elbow condition called lateral epicondylitis. It is an overuse injury that causes inflammation of the tendons that attach to the bony prominence on the outside of the elbow (lateral epicondyle). It is a painful condition occurring from repeated muscle contractions at the forearm that leads to inflammation and micro tears in the tendons that attach to the lateral epicondyle. The condition is more common in sports activities such as tennis and cricket and recreational activities such as painting, hammering, typing, gardening and playing musical instruments. Patients with tennis elbow experience elbow pain or burning that gradually worsens and a weakened grip.

Dr Bala will evaluate tennis elbow by reviewing your medical history, performing a thorough physical examination and ordering X-rays, MRI or electromyogram (EMG)to rule out any nerve compression, instability, arthritis or cartilage loose body.

Conservative treatment is the first recommended option to treat the tennis elbow symptoms. These may include:

  • Limit use and rest the arm from activities that worsen symptoms.
  • Forearm counterforce brace may be ordered to decrease stress on the injured tissues.
  • Apply ice packs on the elbow to reduce swelling.
  • Avoid activities that bring on the symptoms and increase stress on the tendons.
  • Anti-inflammatory medications and/or steroid injections may be ordered to treat pain and swelling.
  • Physiotherapy may be ordered for strengthening and stretching exercises to the forearm once your symptoms have decreased.

If conservative treatment options fail to resolve the condition and symptoms persist for 6 -12 months, a surgical procedure may be recommended to treat tennis elbow called lateral epicondyle release surgery. Dr Bala will discuss with you your surgery in the traditional open manner (single incision) or arthroscopically (2 to 3 tiny incisions and the use of an arthroscope). Together you will decide which options are best for you depending on your specific circumstances. Dr Bala is also trained in Ultrasound guided Minimally invasive tennis elbow release.

With the open approach Dr Bala releases the extensor tendon and its attachment on the lateral epicondyle, trims the tendon or releases the tendon, freshens the tendon bed using a bone rasp and then reattaches it to the bone using a bone anchor if needed. Any scar tissue present will be removed as well as any bone spurs. After the surgery is completed, the incision(s) are closed by suturing.

Following surgery, you may be referred to physiotherapy to improve the range of motion and strength of your joint.