Epicondylitis

What treatments are available for 'Tennis Elbow' and 'Golfers Elbow' ?

Rest is the treatment of choice when the pain first appears. If the pain is severe, short term immobilisation of the arm in a splint may be helpful in some patients. This rest aims to allow the tiny tears in the tendon attachment to heal. Non-specific symptomatic treatments that can be used include non-steroidal anti-inflammatory drugs (NSAIDs),heat or ice. A counter-force brace or “tennis elbow strap” to reduce strain at the elbow can help to limit pain and to protect against further damage. Physiotherapy, including a program of stretching, strengthening and local tissue massage may also provide some benefit.

What other treatments can be used?

A number of other treatment options are available supported by variable degrees of clinical evidence:

• Acupuncture.
• Injection of autologous blood or platelet-rich plasma.
• Extra-corporeal shock wave therapy (ESWT).
• Heat therapy.
• Local injection of cortisone and a local anaesthetic.
• Pulsed ultrasound to break up scar tissue, promote healing, and increase blood flow in the area.
• Sclerotherapy .
• Trigger point therapy.

Surgery?

In cases which fail to resolve with other treatment modalities surgery may be indicated. Many techniques have been described. Most aim to release the strain on the affected muscle origin, remove degenerative tissue and promote healing.

Can these conditions be prevented or a recurrence avoided?

The use of appropriate coaching techniques, training regimes and equipment may be of use in reducing the risk of the condition occuring and minimising the risk of recurrence.