What is it?
These are conditions that affect the outside (tennis elbow) and inside (golfer’s elbow) of the elbow. Although they do occur in tennis players and Golfers they are more common in non-sporting people. They are seen more often in middle-aged people and in males and females equally.
What causes it?
Tennis elbow and Golfer’s elbow are due to inflammation at the site where the muscles of the forearm attach to the bone around the elbow. No one knows exactly what causes these conditions. They rarely affect people past the age of 65.
What are the symptoms?
The patient will experience pain and tenderness over either the outer side or inner side of the elbow. This may follow a period of activity and will get easier after a period of rest. In more severe cases the hand can feel weak and the grip less strong resulting in difficulty performing certain tasks.
How is it diagnosed?
The diagnosis can usually be made in clinic. Occasionally x-rays and other tests are needed.
How is it treated?
The treatment options will be discussed with you. The treatment options are:
Rest: For mild cases a period of rest for 1 to 2 weeks will relieve the symptoms. This is often combined with an avoidance of repetitive handwork and other activities that make the symptoms worse.
Splintage: Also for mild cases, a special pressure pad may help.
Physiotherapy: In more severe cases a course of physiotherapy followed by regular exercise, may help with pain relief.
Injection: Again for more severe cases injection of a local anaesthetic and small amount of steroid can help relieve the pain. Current evidence suggests that these injections provide excellent short-term pain relief but in the medium term, your pain may return. These injections can be repeated if they are of benefit. Occasionally, some of the steroid will leak into the skin resulting in an area of lightening in the skin, which can be permanent.
Surgery: Surgery is reserved for cases that recur or persist despite the other forms of treatment.
What does surgery involve?
Surgery involves freeing or releasing the inflamed area of the elbow. It can be performed under regional anaesthetic (block) or general anaesthetic. Whichever type of anaesthetic you choose, the surgery can be performed as a day case.
What happens after surgery?
A bandage is applied. This may be changed to a lighter dressing after a few days. Any stitches will be removed at 10-14 days. You will be allowed to use your elbow normally at this point. Physiotherapy may be required. The physiotherapist will advise you on exercises. Muscle strengthening exercises are started at about three months.
What are the risks of surgery?
The risks of surgery are rare but include infection, stiffness, and nerve injury.
How successful is surgery?
Surgery is successful in 70 – 80% of cases. When surgery does not relieve the pain, no further treatment has been shown to help.