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Tennis Elbow, why it hurts? Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of tennis elbow-lateral epicondylitis. The tennis elbow is also known as lateral epicondylitis. It is an overuse injury that causes inflammation, tendinosis, and lateral elbow pain at the origin of a small muscle called the extensor carpi radialis brevis (ECRB). The pain is located on the outer side of the elbow. The pain may interfere with sleep and activities or even carry groceries. When this muscle (ECRB) is overloaded by repetitive activities, it causes pain on the outer side of the elbow. I am going to go into some details about this condition. It is the most common cause of elbow pain. 50% of tennis players develop elbows due to technical reasons and risk factors such as incorrect grip size or poor swing technique. This condition also affects workers who do heavy lifting, repetitive gripping, or use heavy tools. The pathology of the tendon shows disorganized collagen and angiofibroblastic hyperplasia. The condition usually starts with microtears of the extensor carpi radialis brevis origin due to eccentric overload, which is precipitated and aggravated by repetitive wrist extension and forearm pronation. The patient with tennis elbow will complain of pain with gripping, decreased grip strength, pain with repetitive wrist extension, and will have tenderness around the lateral elbow. Here is the area of pain for the tennis elbow and radial tunnel syndrome. Radial tunnel syndrome should be in the differential diagnosis of tennis elbow, especially if the patient is not recovering as expected from tennis elbow treatment (suspect that the patient has radial tunnel syndrome). Radial tunnel syndrome causes pain about 3–4cm distal and anterior to the lateral epicondyle. Radial tunnel syndrome occurs in about 5% of the patients due to compression of the posterior intraosseous nerve. You also need to rule out cervical disc problems and tricep tendonitis. The tennis elbow diagnosis was based on the symptoms and physical examination. The provocative test, which will increase the pain at the lateral epicondyle, is resisted wrist extension with the elbow fully extended. You can get X-rays of the elbow, but the X-rays are basically normal, and rarely do you find some calcification. Treatment of tennis elbow: - Activity modification - Nonsteroidal anti-inflammatory medication -Physical therapy (exceedingly eccentric exercises) -Injection (frequently used) -Steroid injection -May use PRP (Ultrasound guidance may be helpful) -Bracing There is a 95% success rate with nonoperative treatment to relieve the pain. It may take up to 6-12 months to improve the condition. Surgery is a resort for releasing and debriding the extensor carpi radialis brevis muscle origin. Excessive debridement and release of the tendon can lead to injury of the lateral collateral ligament, which causes the posterolateral rotatory instability of the elbow.