Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. But several other sports and activities can also put you at risk.

Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists, and, in some cases, surgeons work together to provide the most effective care.

Tennis Elbow Surgery Candidates

For most sufferers of tennis elbow, medically termed lateral epicondylitis, their bodies will heal themselves. The best way to enable this body healing is to rest the elbows by eliminating the most aggravating activities.

Tennis Elbow Surgery Alternatives

If the pain persists for several months, surgery may be advised. Fortunately there are several options for treatment:

• trim abnormal tendons 3-4 cm
• release tendon from bone
• ossatripsy

Before lateral epicondylitis surgery is considered, most doctors will want to make sure that the patient has undergone at least 6 months of conservative treatment.

If tennis elbow surgery is to be considered, due to the inherent risks with any invasive surgery, most doctors will want to make sure that the patient has a pain level that prevents normal activity. Ideally, the patient has been given several cortisone shots with no improvement in the lateral epicondylitis pain.

Tennis Elbow Outcome & Benifits

Various surgical procedures are used to treat tennis elbow. Some surgical research exists. But there are no published, controlled trials that either strongly support or discourage the use of any one procedure or prove that surgery is better than other treatment.

Most people are able to return to their previous activities after tennis elbow surgery. Be sure to change any previous technique, equipment, or activity that has been linked to the elbow pain.

Prepare for Tennis Elbow Surgery

Your doctor will consider many factors in making a diagnosis. These include how your symptoms developed, any occupational risk factors, and recreational sports participation.

Your doctor will talk to you about what activities cause symptoms and where on your arm the symptoms occur. Be sure to tell your doctor if you have ever injured your elbow. If you have a history of rheumatoid arthritis or nerve disease, tell your doctor.

During the examination, your doctor will use a variety of tests to pinpoint the diagnosis. For example, your doctor may ask you to try to straighten your wrist and fingers against resistance with your arm fully straight to see if this causes pain. If the tests are positive, it tells your doctor that those muscles may not be healthy.

Tennis Elbow Surgery Overview

If your symptoms do not respond after 6 to 12 months of nonsurgical treatments, your doctor may recommend surgery.

Most surgical procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to bone.

The right surgical approach for you will depend on a range of factors. These include the scope of your injury, your general health, and your personal needs. Talk with your doctor about the options. Discuss the results your doctor has had, and any risks associated with each procedure.

Surgery for tennis elbow may involve:

• Cutting (releasing) the tendon.
• Removing inflamed tissue from the tendon.
• Repairing (reattaching) tendon tears if it is possible to do so without overtightening the tendon.

Surgery may be done arthroscopically, by traditional open surgery, or by a combination of the two techniques depending on the type of problem and the method the doctor prefers to use. Arthroscopy is not widely used.

Surgery can be done with general or regional anesthetic and can require an overnight stay in the hospital.

Open Surgery

The most common approach to tennis elbow repair is open surgery. This involves making an incision over the elbow.

Open surgery is usually performed as an outpatient surgery. It rarely requires an overnight stay at the hospital.

Arthroscopic Surgery

Tennis elbow can also be repaired using tiny instruments and small incisions. Like open surgery, this is a same-day or outpatient procedure.

Tennis Elbow Surgery Recovery

Following surgery, your arm may be immobilized temporarily with a splint. About 1 week later, the sutures and splint are removed.

After the splint is removed, exercises are started to stretch the elbow and restore flexibility. Light, gradual strengthening exercises are started about 2 months after surgery.

Your doctor will tell you when you can return to athletic activity. This is usually 4 to 6 months after surgery. Tennis elbow surgery is considered successful in 80% to 90% of patients. However, it is not uncommon to see a loss of strength.

Tennis Elbow After Care

In both operations, the patient usually goes home the same day of surgery. An arm sling and occasionally a plaster splint are used. The arm is to be elevated and kept dry. Stitches are removed 5 to 7 days after surgery and motion is begun. Rehabilitation and recovery depend upon the extent of the surgery and the type of surgery done. Most people cannot drive for a week. The success of these operations is generally 85-95% excellent relief from the pain. While return to daily activity without pain is often possible within 3 to 6 weeks, return to sports or heavy use of the arm can take several months.

Tennis Elbow Surgery Possible Risks

As with any invasive surgery, both of the above tennis elbow surgery treatments have to follow risks:

• infection
• bleeding
• nerve damage
• slight loss of the ability to extend ( straighten ) the arm
• a scar on the skin surface that may be painful and/or unsightly
• persistant weakness in the arm and/or wrist

Finally there is the risk that the treatment may not improve the tennis elbow condition at all. There is even the possibility that the pain may be worse. Most patients will have to wait 3-4 weeks after treatment to see if there is any improvement in their pain.