Restoring Function. Embracing Life.
Tennis Elbow Specialist in Singapore
Dr Bryan Wang
Consultant Orthopaedic Surgeon
Trusted Orthopaedic Surgeon | Fellowship-trained in Canada | With over 15-years of experience
What is Tennis Elbow Injury?
Tennis elbow (lateral epicondylitis) is a painful condition of the elbow that occurs when tendons in your elbow are overloaded, usually by repetitive motions of the wrist and arm.
This results in inflammation, and occasionally, microtearing of the tendons that join the forearm muscles on the outside of the elbow. Healing can often be prolonged due to the reduced blood supply to the tendon.
Tennis elbow involves the muscles and tendons of your forearm that are responsible for the extension of your wrist and fingers. Your forearm muscles extend your wrist and fingers. Your forearm tendons — often called extensors — attach the muscles to bone. The tendon usually involved in tennis elbow is called the extensor carpi radialis brevis (ECRB).
Despite its name, athletes are not the only people who develop tennis elbow. People whose jobs feature the types of motions that can lead to tennis elbow include plumbers, painters, carpenters and butchers.
What are the symptoms?
The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.
Common signs and symptoms of tennis elbow include:
Pain or burning on the outer part of your elbow
Weak grip strength
Sometimes, pain at night
The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is most often affected; however, both arms can be affected.
How to Diagnose?
Clinical assessment will include taking a detailed history and a thorough examination of your elbow.
Further imaging tests like X-rays, MRI scans and ultrasound scans may occasionally be required.
Tennis Elbow Injury Treatment
What are my Treatment options?
If you have any of the symptoms above, it is advisable to see an orthopaedic specialist for further assessment. The appropriate treatment is decided after assessment and a collaborative discussion based on your needs. They can be broadly divided into conservative (non-surgical) and surgical options.
Conservative Treatment
Non-surgical measures will usually be recommended first if you have not had any prior treatment for your tennis elbow. Majority of patients do well with non-surgical management.
Rest
Minimise activities which aggravate the pain (sports, manual work, housework)
Medications
Anti-inflammatory drugs to reduce pain and swelling
Brace
Using a brace centred over the back of your forearm may reduce symptoms by resting the muscles and tendons
Cortisone injection
Steroids are very effective anti-inflammatory medicines. This may be necessary if the pain is persistent despite the above measures
Platelet-rich plasma (PRP)
This is a biological treatment designed to improve the biologic environment of the tissue. While some studies about the effectiveness of PRP have been inconclusive, others have shown promising results.
Surgical Treatment
If your symptoms remain persistent despite all the above measures, surgery may sometimes be required.
Most surgical procedures for tennis elbow involve removing the unhealthy tendon, improving the blood supply, and reattaching the healthy tendon back to bone.
The appropriate surgical treatment will depend on the nature of the tear as well as your needs (age, functional demands).
Open surgery
This involves making a small incision over the lateral epicondyle. The unhealthy tendon is removed and the remaining healthy tendons are reattached.
Arthroscopic surgery (keyhole)
This is performed using small incisions and instruments. This is useful when there are other issues within the elbow joint that needs to be treated (ie loose bodies, bone spurs).
