Epicondylitis of the Elbow – Golfer’s and Tennis Elbow
The epicondyles are two bumps located on the inside and outside of the elbow where muscle tendons and ligaments attach. The medial epicondyle is located on the inside of the elbow and the lateral epicondyle is located on the outside of the elbow. When the inflammation and tearing of the attached tissues occurs on the medial side it is commonly called “Golfer’s Elbow” and when this occurs on the outside it is commonly called “Tennis Elbow”. These injuries are very commonly repetitive use injuries resulting in cumulative trauma.
Symptoms of medial epicondylitis are often made worse by making a fist and lifting objects as well as playing golf. Symptoms of tennis elbow are often made worse with grasping of objects. Both can have increased pain associated with twisting of the wrist/forearm.
Treatment of Epicondylitis
Tendonitis can often be successfully treated with non-operative measures. This can include observation, avoidance of the causative activities, bracing, icing and anti-inflammatory medications (oral and injectable). Additionally, physical therapy exercises can help to maintain range of motion and strengthen the muscles. If a reasonable course of non-operative treatment has failed then surgical interventions may be indicated.
Multiple techniques have been described to treat medial and lateral epicondylitis. Original methods for treatment included an open incision over the region of the damaged tendon and epicondyle. Newer techniques have been developed including arthroscopic techniques as well as a percutaneous ultrasound guided technique. This is Dr. Lenarz’s preferred technique (Tenex Procedure). The ultrasound guided technique offers many advantages. It is done through a single small incision, requiring no sutures. It is done completely under local anesthetic (you are awake throughout the procedure) and can even be done in the office.