Symptoms of Lateral Epicondylitis

The most common complaint of tennis elbow or lateral epicondylitis is tenderness and pain over the lateral epicondyle on the outside of the elbow. Other symptoms include:

• A constant dull ache on the outside of the affected elbow

• Radiating pain into the upper or lower arm

• A weak grip making it difficult to turn a doorknob or hold a cup of coffee

Dr. Koscso can diagnose tennis elbow after performing a comprehensive medical history and physical examination. Some specific testing during the physical examination may include palpating over the lateral epicondyle of the affected elbow and straightening of the wrist and fingers against resistance. Diagnostic imaging, including x-rays and magnetic resonance imaging (MRI), may be requested to identify damage to any other structures within the elbow joint, rule out bone abnormalities, and check for torn or damaged tissue.

Non-Surgical Treatment

Lateral epicondylitis is most commonly treated successfully with non-surgical therapy alone. A combination of rest and oral non-steroidal anti-inflammatory medications (ibuprofen, naproxen, meloxicam, etc.) can significantly reduce pain symptoms while the injured tendon is healing. Ultimately, once pain is controlled, a guided physical therapy regimen is crucial to correcting shoulder and elbow muscle imbalances are regaining strength in the upper limb.

On occasion, particularly in patients with refractory symptoms despite the above interventions, an injection into the tendon may be offered to minimize pain and/or optimize healing of the injured tendon. There are a couple injection therapies that you may discuss with Dr. Koscso at your visit. These include:

• Corticosteroid injection with the goal of reducing pain and inflammation so that ongoing physical therapy and strengthening of the elbow may be carried out.

• Platelet-rich plasma injection with the aim of optimizing the healing environment around the injured tendon.

Both of these injection therapies carry slightly different aims and side effect profiles which can be discussed at your visit.

Surgical Treatment

For patients that experience more severe elbow pain, or when conservative therapy is unsuccessful, surgical repair of the injured tendons may be necessary. Dr. Koscso can repair the damaged tissue with a minimally invasive surgical method using a small incision made in the area of the damaged tendons. In this procedure, the portion of diseased tendon is removed (since it has exhausted its healing capacity) and the remaining healthy tendon is then reattached to the lateral epicondyle bone using small sutures and anchors. For patients who have not been relieved with the non-surgical interventions above, surgery has a high probability of restoring their desired elbow function.