Tennis Elbow
Background
- Overuse tendinopathy of common extensor origin at the elbow
- Mostly recent new exercise/activity
- If tennis - backhand painful
Clinical
- Pain on (resisted) extension of wrist/fingers
- Pain on (resisted) supination of the forearm/wrist
- Tenderness at the lateral epicondyle
- Normal elbow ROM
Management
- Avoid steroid injections (ahrmful long term)
- NSAIDs
- Avoid triggering exercise (or occupation)
- Remove tendon overload
- Education and exercise are treatment of choice
- Trial of (expensive, unproven) physiotherapy?
- An elbow clasp may help in the short term [BestBets]
- There is some weak evidence for electrotherapy (laser) [BestBets]
- Consider hyaluronan gel injections and nitrate patches
- Consider extracorporeal shockwave therapy for refractory tennis elbow [NICE P1773]
- Consider botulinum toxin injections for the worst cases
- Many cases of tennis elbow cases will naturally resolve in 6-12 months
Content by Dr Íomhar O' Sullivan 13/05/2011. Last review Dr ÍOS 18/06/21
