Lateral Epicondylitis (Tennis Elbow)
Overview: Lateral Epicondylitis is an inflammation of the tendons on the outer portion of the elbow. This group of tendons is connected to a group of muscles that helps to extend the wrist and fingers of that arm.
Causes: Repetitive motion including wrist extension or prolonged gripping are risk factors for developing tennis elbow.
Symptoms: Pain or burning within the outer elbow and associated weakness of grip strength on the affected side are common. The symptoms usually begin slowly and progress over time.
Treatment: Up to 95% of patients improve with conservative care. Anti-inflammatory medications and topical agents can be effective. Bracing with a tennis elbow brace can allow muscles and tendons to rest and can help reduce symptoms. Checking the equipment that is being used at work or during sports can help to prevent additional symptoms. Physical therapy or occupational therapy can provide education on how to appropriately stretch and strengthen the elbow tendons and muscles. Rather that performing a local steroid injection into the region, which can damage local tissue, the newer standard of care is to place platelet-rich fibrin over the damaged portion of the tendon to promote healing and reduce inflammation and pain. Surgical debridement of the tendons is reserved for patients that fail more conservative measures and is very seldom necessary.
Medial Epicondylitis (Golfer’s Elbow)
Overview: Medial Epicondylitis is an inflammation of the tendons on the inner portion of the elbow. This group of tendons is connected to a group of muscles that helps to flex the wrist and fingers of that arm.
Causes: Repetitive motion including wrist flexion or prolonged gripping are risk factors for developing tennis elbow. Throwing sports also have an increased risk for developing medial epicondylitis.
Symptoms: Pain or burning within the inner elbow and associated weakness of grip strength on the affected side are common. The symptoms usually begin slowly and progress over time.
Treatment: Up to 95% of patients improve with conservative care. Anti-inflammatory medications and topical agents can be effective. Bracing with a tennis elbow brace can allow muscles and tendons to rest and can help reduce symptoms. Checking the equipment that is being used at work or during sports can help to prevent additional symptoms. Physical therapy or occupational therapy can provide education on how to appropriately stretch and strengthen the elbow tendons and muscles. Rather that performing a local steroid injection into the region, which can damage local tissue, the newer standard of care is to place platelet-rich fibrin over the damaged portion of the tendon to promote healing and reduce inflammation and pain. Surgical debridement of the tendons is reserved for patients that fail more conservative measures and is very seldom necessary.
Olecranon Bursitis
Overview: Bursa are fluid-filled sacs that are found in several locations within the body. Their function is to reduce friction and improve movement. Bursa may become irritated and inflamed when excessive stress is placed on them or following direct trauma.
Causes: The olecranon is the bony point at the back of the elbow, and represents the upper part of the ulna bone of the forearm. The olecranon bursa sits directly over the point of the elbow to protect the bone and allow improved movement in the region. Trauma to the region, repetitive elbow movements and infection are some major causes of olecranon bursitis.
Symptoms: Swelling over the back of the elbow is frequently seen. Tenderness of the region may be felt, but elbow range of motion impairment is uncommon.
Treatment: A minor case of olecranon bursitis may be monitored and will likely resolve without treatment. Otherwise, oral or topical anti-inflammatory medication can be used to decrease minor inflammation. A PRP or steroid injection into the bursa under ultrasound guidance may be pursued but is often not necessary. Surgical removal of the bursa is reserved for severe cases of bursitis that have failed more conservative measures.