What is the lateral epicondyle?
The lateral epicondyle is the bony bump on the outside of the elbow. The tendons that pull the wrist back (extensor tendons) join together and are fixed to the elbow at the lateral epicondyle.
What is lateral epicondylitis?
Lateral epicondylitis is probably caused by damage to the extensor tendons as they join the elbow. The tendons can be damaged by tennis players, or more often, by any repetitive motions. Early on, the tendons become inflamed but with time they scar and tear.
What are the symptoms?
Elbow pain: is the most common symptom. Pain is felt around the outside of the elbow and is worsened by bending the wrist. The pain may follow a period of increased activity and usually improves with rest.
Tenderness: occurs over the lateral epicondyle.
Weakness of grip: may occur in severe cases.
What tests are needed?
Elbow X-rays can show calcification of the tendons or a spur on the lateral epicondyle.
Sometimes special tests may be necessary such as an MRI scan.
What are the treatments for lateral epicondylitis?
Rest: Avoiding repetitive motions may relieve symptoms.
Brace: Use of a brace with a special pressure pad can help.
Hand / Physiotherapy: Many patients respond to treatment by a therapist and oral medications including painkillers and an anti-inflammatory.
Cortico-steroid injection: If pain is troublesome, then an injection of a local anaesthetic and steroid may be needed. This injection sometimes worsens the pain for a short time before it settles. A maximum of three injections can be given in any one year.
Surgery: involves trimming the damaged tendons and bone of the lateral epicondyle. This is usually done as a day case under general anaesthetic. The elbow is placed in a splint at surgery and this is worn for 2 - 3 weeks. After surgery, a brace and therapy is required for 6 - 12 weeks.
What are the risks?
There are risks with the surgery and general anaesthetic. Pain may continue despite surgery or may take many months to improve. Infection and nerve irritation are rare but can occur with the surgery.
The risks of the general anaesthetic should be discussed with the anaesthetist.