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Lisa R. Reznick MD, PA

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Tennis Elbow - Lateral Epicondylitis

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Tennis Elbow is a condition that results in deterioration of the tendon fibers that attach to the bone at the outside of the elbow. Tendons are strong fibers that attach muscles to bone. They are tissues that do not stretch easily and are susceptible to degeneration under repeated or traumatic stress. Another name for Tennis Elbow is Lateral Epicondylitis. The pain of Tennis Elbow occurs primarily where the tendons of the forearm muscles attach to the elbow bone at the Lateral Epicondyle. Playing racquet sports is only one cause of Tennis Elbow. However, most individuals with Tennis Elbow participate in work or activities that require repeated use of the forearm muscles.

Read more about Tennis Elbow - Lateral Epicondylitis

  • Introduction
  • Anatomy
  • Causes
  • Symptoms
  • Diagnosis
  • Treatment
  • Surgery
  • Recovery
  • Introduction
  • Anatomy
  • Causes
  • Symptoms
  • Diagnosis
  • Treatment
  • Surgery
  • Recovery

Introduction

Tennis Elbow is a condition that results in deterioration of the tendon fibers that attach to the bone at the outside of the elbow. Tendons are strong fibers that attach muscles to bone. They are tissues that do not stretch easily and are susceptible to degeneration under repeated or traumatic stress. Another name for Tennis Elbow is Lateral Epicondylitis. The pain of Tennis Elbow occurs primarily where the tendons of the forearm muscles attach to the elbow bone at the Lateral Epicondyle. Playing racquet sports is only one cause of Tennis Elbow.

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Anatomy

A tendon anchors the forearm muscles to the outer (Lateral) side of the elbow bone (Epicondyle). The forearm muscles, particularly one called the Extensor Carpi Radialis Brevis, work together to raise the hand at the wrist joint. These forearm muscles are called the “wrist extensors” because they allow the hand to move upward or extend, such as when making the hand motion for “stop.” Repeated use of the wrist extensors can cause microscopic tears in the tendon. Individuals with tendon tears or degeneration can develop forearm muscle weakness along with swelling and pain at the outside of the elbow.

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Causes

Tennis Elbow most commonly occurs in individuals between the ages of 30 and 50 years old. Tennis Elbow is caused by chronic stress to the forearm muscles, especially the Extensor Carpi Radialis Brevis. The repeated motions and stress can cause the tendon to degenerate (tendonopathy). As the name Tennis Elbow implies, playing tennis or other racquet sports is one cause of the condition; particularly, repeated use of the backhand stroke, forearm stroke, or serve with poor athletic form. Many individuals develop Tennis Elbow for no identifiable reason.

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Symptoms

Individuals with Tennis Elbow frequently experience severe burning pain and tenderness at the outer side of their elbow and forearm. In most cases, the pain starts out slow and mild but gradually increases over weeks or months. The pain may increase with movement or when pressure is applied to the outer elbow area. Some individuals experience morning stiffness, muscle weakness, and aching throughout the day. They may be unable to perform the motions necessary to complete various tasks. Some individuals may even feel pain when they are not moving their arm.

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Diagnosis

A physician will perform an examination and review the individual’s medical and activity history to make a diagnosis of Tennis Elbow. The physician evaluates the forearm structures by using simple tests. The history and examination, supplemented with X-rays of the elbow are sufficient to make the diagnosis. X-rays may be used to assess if the elbow bone was injured and help rule out other possible causes of elbow pain, such as arthritis. When taking an x-ray, a camera focuses on the elbow area and a picture is taken. Magnetic Resonance Imaging (MRI) scans are rarely used to diagnose Tennis Elbow however MRI scans may be used to provide a very detailed view of the tendon injury. The MRI equipment takes images by focusing on the elbow area. Both imaging techniques are painless and require that the individual remain very still.

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Treatment

Most cases of Tennis Elbow respond to non-surgical treatments. Treatment typically includes rest or activity restriction/alteration. Specific exercises, often under the guidance of a therapist, are often prescribed. Physicians may instruct the application of ice to the affected areas or recommend medication to relieve pain. Wrist splints and forearm bands can be used to relieve symptoms and promote healing.

 

Tennis Elbow may also be treated with corticosteroid medications. Corticosteroid medication is a relatively safe pain reliever and in the case of tennis elbow would be injected at the outside of the elbow. After the pain is relieved, physical or occupational therapy may be needed. The physical or occupational therapists focus on improving physical functioning for participation in activities. The therapies address muscle strength, flexibility, endurance, and coordination. This method is successful for many individuals with Tennis Elbow.

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Surgery

The majority of individuals with Tennis Elbow do not require surgery. Surgery is considered if significant pain continues after at least six months of treatment. The surgery is performed as an outpatient procedure. The individual may remain alert with regional anesthesia or be sedated for the surgery. The surgeon makes a small opening at outside of the elbow bone and then removes any injured tissue and reattaches the tendon to the bone. Recently, an arthroscopic surgery method has been developed. Arthroscopic surgery uses a small camera, called an arthroscope, to guide the surgery. Only small incisions need to be made and the joint does not have to be opened up fully. This technique can provide a positive outcome and a shortened recovery time.
 

Following surgery, the elbow is placed in a small splint. After about one week, the individual can begin physical or occupational therapy to stretch the elbow joint and increase motion. Muscle strengthening can begin at about two months after the surgery. Individuals typically return to full activity levels four to six months after surgery. Tennis Elbow surgery produces successful outcomes for the vast majority of individuals.  

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Recovery

With non-surgical treatments, symptoms of Tennis Elbow may be relieved as early as four to six weeks. However, many individuals have chronic symptoms for many months. Individuals requiring corticosteroid injections or surgery may take several months to recover, but typically can achieve good results. Tennis Elbow does not usually lead to severe problems if it is treated. If left untreated, it rarely leads to loss of motion and function.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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Dr. Reznick did major surgery on my right hand (carpal tunnel and 3 trigger fingers). Prior to the surgery, I could not hold a pen or write my name legibly. I was in constant pain. After the surgery, while the stitches were still in and the brace still in place, I had more flexibility in my fingers than I had before the surgery. I am six weeks out from the surgery and I continue to progress. I have more functionality and strength in my hand than I have had in the last year. I can't even see the scars on my hand. Dr. Reznick not only did a spectacular job of restoring the use of my hand, but she is a very likable person. Her staff is friendly and professional. I cannot say enough good things about this experience!

Nancy L.

via md.com

Seeing Dr. Reznick and being treated by her is like going to heaven with millions of angels. She can not only treat your hand, she treats the soul. She is the best!!!

Les D.

via healthgrades.com

Amazing visit. I can't remember the last time I spent quality time with a doctor. She explained everything to me on why I was having trigger finger issues. I have been dealing with this for some time. She nailed it on the first visit ‘cause she talks to you and listens! If you need a hand doctor you will be happy she is the one.

Anonymous

via healthgrades.com

Dr. Reznick is one of the most professional, sensitive and caring physicians I have visited. She is a teacher--patient and informative, and she made sure I understood just exactly what was necessary for my particular problems. She took care of both my left and right carpal tunnel surgeries, and I couldn't have asked for a better recovery. Everything went just as planned. She is my ‘go to’ hand doctor!

Anonymous

healthgrades.com

When I was having problems with my wrist, she guided me through every step, and always made sure I was comfortable with what she was doing. Very straightforward and trustworthy. I never doubted what she was doing and she always wants to try every technique before doing surgery to try to make you better.

Shannon C.

healthgrades.com

I recently rode 900 miles on a vibrating Harley-Davidson and did not have a single tingle in either of my hands. You do great work. Thanks for helping me.

Ed G.

Just wanted to let you know again how much I appreciated your care, expertise and skill in conducting the surgery on my hand. A job well done. Thank you.

Randall A.

My surgery went very well. My banjo and I thank you.

Kevin M.

Dr. Lisa Reznick has performed carpal tunnel surgery on both hands and has removed my basal joint from my right hand. All of my surgeries have been successful, and I now have complete use of both hands and my right thumb, which I credit to a great surgeon, good therapy, and a genuine concern for patients.

Robert

My hand is in perfect working order because of your expertise. I appreciate your genuine concern for my healing. Through the myriad of maladies my husband experienced, I became acquainted with many doctors. None even approached your level of patient care.

Trudy R.

Dr. Reznick performed surgery on my hand for ‘trigger finger’ and did a wonderful job. I’ll definitely user her again if the need ever presents itself again.

Don L.

Dr. Reznick is very to the point and no nonsense. She tells you what options there are in your treatment and advises you accordingly. I had hand surgery four years ago and it was a complete success. I actually went back to work one week early. I have recommended Dr. Reznick to many friends and associates. Frankly, I won’t go to anyone else when it comes to muscles or bones. I have complete faith in her.

J. Schully

via vitals.com
Testimonials

Dr. Reznick did major surgery on my right hand (carpal tunnel and 3 trigger fingers). Prior to the surgery, I could not hold a pen or write my name legibly. I was in constant pain. [Now] I have more functionality and strength in my hand than I have had in the last year. I can't even see the scars on my hand. Dr. Reznick not only did a spectacular job of restoring the use of my hand, but she is a very likable person. Her staff is friendly and professional. I cannot say enough good things about this experience!

~ Nancy L. via md.com

Lisa R. Reznick MD, PA

Board Certified Orthopedic and Hand Surgeon

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4100 Fairway Court, Suite 120
Carrollton, TX 75010
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In Carrollton, TX, board-certified orthopedic surgeon Dr. Lisa Reznick offers conservative treatment options for all types of general orthopedic issues, while specializing in surgeries of the hand, wrist, and elbow.