Lateral epicondylitis, commonly called tennis elbow, is a painful inflammatory condition felt at the outside of the elbow. While the condition is often associated with tennis, it can also occur from occupational overuse from repetitive twisting motions.
Tennis elbow is marked by pain, burning and tenderness at the outside of the elbow, usually on the dominant arm. Inflamed tissue may feel warm to the touch. Pain may escalate when carrying objects with an extended elbow, or during rotating motions like opening a jar or turning a doorknob.
There are four subcategories of lateral epicondylitis:
Clinical diagnosis begins with a health history and physical exam. Diagnostic ultrasound may be used to confirm diagnosis and rule out other causes of elbow pain.
Some conditions that mimic tennis elbow include:
A 48 year old female writer presented at our clinic with pain in her lateral elbow. She had been diagnosed with lateral epicondylitis, and treated with steroid injections. When her symptoms were not resolved, she went to another practitioner who treated her elbow with extracorporeal shock wave therapy (ESWT) and five months of physical therapy. Nine months later, she was still in pain.
We used diagnostic ultrasonography to examine her elbow, and found no evidence of tendinosis at the lateral epicondyle, but we did discover a compression of the posterior interosseous nerve (PIN), which is a common mimicker of tennis elbow, and which is easily missed on MRI. Diagnostic ultrasound provides a clear image of the structures of the elbow in motion, in real time, offering precise insight into the nature and cause of the patient’s elbow pain. Early diagnosis with ultrasound can spare the patient ineffective conservative treatment approaches, and unnecessary surgery.
There are several risk factors that predispose a patient to tennis elbow:
Poor grip strength associated with disrupted coordination of the shoulder-elbow-wrist connection is a primary dysfunction of people with tennis elbow, which in turn leads to pain in the lateral epicondyle. Therapeutic exercise has long been the mainstay of treatment for severe elbow pain. Isometric exercise is sometimes effective in reducing pain when held in a non-compressed position. Extracorporeal shockwave therapy has been shown to have a high rate of success in treating lateral epicondylitis.
At NYDNR, we use a holistic and comprehensive approach to treat our patients with tennis elbow pain. After diagnosis using real-time ultrasound, we follow up with innovative therapeutic treatments, including:
For the best elbow pain treatment to help you heal quickly and improve your performance, contact NYDNR today. We are the very best clinic to treat tennis elbow in NYC.