Tennis and golfers elbow are conditions involving the tendon insertions around the elbow. They are generally due to tendinopathy (Wear and tear) of important muscles and tendons of the forearm and hand.
There are bony prominences on the outside and inside of your elbow called the epicondyles. This is where several important muscles that move our forearm and hands attach via their tendons. Inflammation of the insertion of the tendons can be brought on by repeated activity, a sudden increase or change in activity or injury, for example, starting a new sport or training for an event. It can also occur as part of wear and tear changes in the elbow tendons that occur as we get older.
Tennis elbow is tendinopathy and or inflammation around the lateral epicondyle or outside of the elbow and Golfers elbow is tendinopathy and or inflammation around the medial epicondyle or inside of the elbow.
What are the symptoms of tennis and golfers elbow?
The symptoms of tennis elbow are usually pain around the outside of the elbow. You don’t necessarily need to play tennis! This can make doing many daily activities such as lifting and pouring a kettle painful and may interfere with a range of sports and activities.
The symptoms of golfers elbow are usually pain around the inside of the elbow. Again, you don’t need to play golf to get golfers elbow! This can make activities that require gripping objects very painful and sometimes may be associated with inflammation of the ulnar nerve, which travels very close to the muscular insertion, leading to pins and needles in the little and ring fingers.
I couldn’t ask for better. I have had excellent consultations with Mr Edwards. He explains and I understand.
RG 2019
How do you diagnose tennis or golfers elbow?
This is typically made clinically from a history and examination, however in most cases plain XRs and either an ultrasound scan or MRI scan may be performed to confirm the diagnosis.
How do you treat tennis or golfers elbow?
Physiotherapy has been established in the medical literature as the most effective treatment for both Tennis and Golfers elbow. Physiotherapy needs to be done for at least 3 to 6 months before a judgement can be made on its effectiveness. The use of a tennis elbow brace may also be suggested.
The use of injections in to or around the tendon insertion, such as steroids and platelet rich plasma do not have any strong medical evidence in the treatment of these conditions.
However, where patients struggle to engage in therapy due to pain, I may recommend an ultrasound guided injection of steroid and anaesthetic in to the area as a ‘pain breaker’, to allow you to engage fully with the physiotherapy. According to the literature, it is the physiotherapy that will make you better, not the injection.
In some cases, the symptoms may improve for a time, but then return or may not respond to non-operative measures. In these circumstances an operation may be recommended.
For either condition an operation to remove the worn tendon and repair any tears may be advised. A small incision is made around the elbow to allow this to be performed. It is done as a day case operation under a general anaesthetic.