Tennis Elbow & Golfer's Elbow
Tennis elbow and golfer's elbow are also called lateral epicondylitis and medial epicondylitis respectfully. They represent inflammation and partial tears of the ligamentous structures which are the origin for both the wrist extensors in the case of lateral epicondylitis and the wrist flexors in the case of medial epicondylitis. In addition to being caused by sporting events, it can be caused by direct trauma to the elbow and/or lifting. Initial treatment consists of anti-inflammatory medication or an injection of cortisone into the area of maximal tenderness. In addition, splinting can be utilized to put the wrist at rest, thus taking tension off the origin of the respective muscles. If this treatment is not effective, then therapy is next indicated.
This can include a stretching and strengthening program for either the wrist extensors and/or flexors and the use of iontophoresis with Dexamethasone. Surgery is the last resort and is only utilized when there is a failure of the above conservative management over a period of several months. Surgical intervention consists of actually debriding the chronically inflamed tissue and a shaving down of the bone at the level of the lateral epicondyle or medial epicondyle in an effort to promote healing of the tendinous structures back down to their origin. Postoperative course includes splinting for approximately 2 weeks and then a subsequent therapy program.