What is Tennis Elbow?
Tennis elbow is a common condition, which affects many people, both men and women. The exact cause of it is not known, however, it is typically seen in people with repetitive activities, whether this be work or sports related.
Sometimes symptoms can begin with a minor injury but often there is no particular traumatic event and the pain and dysfunction seen in this condition starts spontaneously.
Pain is experienced on the outside aspect of the elbow, and is usually worse when performing those activities, which have brought the condition on. Elbow movement is not usually effected, but the pain can make the elbow feel stiff and uncomfortable.
Many treatment modalities have been used for the management of this condition and in that fact alone demonstrates that no one particular intervention is any more successful than any of the others.
Initially treatments are usually confined to rest and modification of exacerbating activities together with the use of oral anti-inflammatory medications or topically applied anti-inflammatory gels.
If these treatments fail then the next line of treatment usually involves cortisone injections and physiotherapy.
Cortisone injections are commonly used for tennis elbow and usually provide good short term relief of pain, weeks or sometimes even months.
Usually it is best to combine physiotherapy treatment at this pain free time to maximise the outcome. These injections are not usually effective in the long term if the condition is chronic (more then 3 months of symptoms).
Multiple cortisone injections have also been shown scientifically to be detrimental to tendon tissue.
PRP Injections are a cutting edge new form of treatment for tennis elbow, and have been used by high profile athletes such as Rafal Nadal and Tiger Woods.
Should non-operative measures fail then surgery can be considered. However, surgery like the other treatment modalities, is not guaranteed to cure the symptoms.
Often patients find that they have tried all other non-operative treatment modalities and feel that they have no alternative but to consider surgery, even with the risk of failure.
The results from long-term studies would indicate that symptoms can significantly be improved with surgery on a rate of between
In Mr Matthews’ experience, with the technique that he uses, significant improvement in symptoms occurs in 90% of patients at
Surgery is usually undertaken as a day procedure under general or regional anaesthetic and usually takes no more than 45 minutes from going off to sleep to waking up.
Immediately following surgery, you will have a bandage around the arm and a sling to go home with. The sling can be removed at any time as comfort allows and needs to be discarded within 48 hours of the surgery to allow the elbow to begin moving.
The bandage will prevent excessive movement of the elbow in the first 10 days to 2 weeks while the wound heals. At 10 days to 2 weeks the wound is reviewed and stitch ends can be trimmed and more formal movement can commence. It is important not to do any heavy lifting in the first 6 weeks after surgery as this could disrupt the repair process.
Physiotherapy rehabilitation usually commences around 2 to 3 weeks following surgery and involves range of movement exercises together with a stretching and strengthening programme.
In Mr Matthews’ experience, at the first formal follow-up appointment at 6 weeks, those patients that are likely to make a significant improvement in their pre-operative symptoms, have discovered that their pain is much improved. Improvement can continue for up to a further 6–9 months even after that.
Whilst the surgery is relatively minor, there are still risks involved, which include infection (<1%), bleeding (<1%), damage to nerves (<1%), scar irritability and mild elbow stiffness.