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Lateral Epicondylitis Follow-up

  • Author: Bryant James Walrod, MD; Chief Editor: Craig C Young, MD  more...
 
Updated: Mar 20, 2016
 

Return to Play

Gradual return to play is recommended, with an emphasis on the patient employing improved form to avoid aggravating activities and techniques. The athlete should be able to perform pain-free ROM activities. Continued attention should be placed on a strengthening and conditioning program.

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Complications

The most serious complication is complete tendon rupture. Such an injury often causes a palpable defect in the extensors, which results in weakness on attempted wrist extension. Frequently, the treatment of this complication is surgical repair.

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Prevention

See the list below:

  • Attention to proper form and technique will decrease the risk of developing tendinosis of the lateral elbow extensor muscles.
  • Proper equipment, (ie, size and weight of racquet, size of grip, dry balls)
  • Improved conditioning, improved core strength
  • Gradual increase in intensity and duration of activity
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Prognosis

Although most patients with lateral epicondylitis tend to improve in 9-18 months, they need to be made aware that successful treatment may be a prolonged course. Refractory cases may need surgical intervention.

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Education

Advise the athlete on proper technique and equipment. Formal sport lessons may be beneficial to prevent individuals from acquiring bad habits.

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Contributor Information and Disclosures
Author

Bryant James Walrod, MD Assistant Clinical Professor, Department of Family Medicine, Ohio State University College of Medicine; Team Physician, OSU Athletic Department

Bryant James Walrod, MD is a member of the following medical societies: American Academy of Family Physicians, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Andrew D Perron, MD Residency Director, Department of Emergency Medicine, Maine Medical Center

Andrew D Perron, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Sports Medicine, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References
  1. Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006 Nov 4. 333(7575):939. [Medline]. [Full Text].

  2. Altan L, Kanat E. Conservative treatment of lateral epicondylitis: comparison of two different orthotic devices. Clin Rheumatol. 2008 Aug. 27(8):1015-9. [Medline].

  3. Jafarian FS, Demneh ES, Tyson SF. The immediate effect of orthotic management on grip strength of patients with lateral epicondylosis. J Orthop Sports Phys Ther. 2009 Jun. 39(6):484-9. [Medline].

  4. Lebiedziński R, Synder M, Buchcic P, Polguj M, Grzegorzewski A, Sibiński M. A randomized study of autologous conditioned plasma and steroid injections in the treatment of lateral epicondylitis. Int Orthop. 2015 Nov. 39 (11):2199-203. [Medline].

  5. Herquelot E, Guéguen A, Roquelaure Y, Bodin J, Sérazin C, Ha C, et al. Work-related risk factors for incidence of lateral epicondylitis in a large working population. Scand J Work Environ Health. 2013 Nov. 39(6):578-88. [Medline].

  6. Roetert EP, Brody H, Dillman CJ, Groppel JL, Schultheis JM. The biomechanics of tennis elbow. An integrated approach. Clin Sports Med. 1995 Jan. 14(1):47-57. [Medline].

  7. Rossi J, Vigouroux L, Barla C, Berton E. Potential effects of racket grip size on lateral epicondilalgy risks. Scand J Med Sci Sports. 2014 Mar 20. [Medline].

  8. Li FX, Fewtrell D, Jenkins M. String vibration dampers do not reduce racket frame vibration transfer to the forearm. J Sports Sci. 2004 Nov-Dec. 22(11-12):1041-52. [Medline].

  9. Lin CL, Lee JS, Su WR, Kuo LC, Tai TW, Jou IM. Clinical and Ultrasonographic Results of Ultrasonographically Guided Percutaneous Radiofrequency Lesioning in the Treatment of Recalcitrant Lateral Epicondylitis. Am J Sports Med. 2011 Aug 11. [Medline].

  10. Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg Am. 2003 Mar. 28(2):272-8. [Medline].

  11. Connell DA, Ali KE, Ahmad M, Lambert S, Corbett S, Curtis M. Ultrasound-guided autologous blood injection for tennis elbow. Skeletal Radiol. 2006 Jun. 35(6):371-7. [Medline].

  12. Wolf JM, Ozer K, Scott F, Gordon MJ, Williams AE. Comparison of autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: a prospective, randomized, controlled multicenter study. J Hand Surg Am. 2011 Aug. 36(8):1269-72. [Medline].

  13. Pattanittum P, Turner T, Green S, Buchbinder R. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database Syst Rev. 2013. 5:CD003686. [Medline].

  14. Nilsson P, Baigi A, Swärd L, Möller M, Månsson J. Lateral epicondylalgia: a structured programme better than corticosteroids and NSAID. Scand J Occup Ther. 2012 Sep. 19(5):404-10. [Medline].

  15. Kazemi M, Azma K, Tavana B, Rezaiee Moghaddam F, Panahi A. Autologous blood versus corticosteroid local injection in the short-term treatment of lateral elbow tendinopathy: a randomized clinical trial of efficacy. Am J Phys Med Rehabil. 2010 Aug. 89(8):660-7. [Medline].

  16. Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaou A. Platelet-Rich Plasma Versus Autologous Whole Blood for the Treatment of Chronic Lateral Elbow Epicondylitis. Am J Sports Med. 2011 Aug 2. [Medline].

  17. Altan L, Kanat E. Conservative treatment of lateral epicondylitis: comparison of two different orthotic devices. Clin Rheumatol. 2008 Mar 26. epub ahead of print. [Medline].

  18. Borkholder CD, Hill VA, Fess EE. The efficacy of splinting for lateral epicondylitis: a systematic review. J Hand Ther. 2004 Apr-Jun. 17(2):181-99. [Medline].

  19. Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005 Jul. 39(7):411-22; discussion 411-22. [Medline].

  20. Jafarian FS, Demneh ES, Tyson SF. The immediate effect of orthotic management on grip strength of patients with lateral epicondylosis. J Orthop Sports Phys Ther. 2009 Jun. 39(6):484-9. [Medline].

  21. Garg R, Adamson GJ, Dawson PA, Shankwiler JA, Pink MM. A prospective randomized study comparing a forearm strap brace versus a wrist splint for the treatment of lateral epicondylitis. J Shoulder Elbow Surg. 2010 Jun. 19(4):508-12. [Medline].

  22. Buchbinder R, Green SE, Youd JM, et al. Shock wave therapy for lateral elbow pain. Cochrane Database Syst Rev. 2005 Oct 19. CD003524. [Medline].

  23. Smidt N, Assendelft WJ, Arola H, et al. Effectiveness of physiotherapy for lateral epicondylitis: a systematic review. Ann Med. 2003. 35(1):51-62. [Medline].

  24. Ramsay DJ, Bowman MA, Greenman, PE, et al, for the NIH Consensus Panel. NIH Consensus Conference. Acupuncture. JAMA. 1998 Nov 4. 280(17):1518-24. [Medline].

  25. Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg [Am]. 2003 Mar. 28(2):272-8. [Medline].

  26. Ozturan KE, Yucel I, Cakici H, Guven M, Sungur I. Autologous blood and corticosteroid injection and extracoporeal shock wave therapy in the treatment of lateral epicondylitis. Orthopedics. 2010 Feb. 33(2):84-91. [Medline].

  27. Kazemi M, Azma K, Tavana B, Rezaiee Moghaddam F, Panahi A. Autologous blood versus corticosteroid local injection in the short-term treatment of lateral elbow tendinopathy: a randomized clinical trial of efficacy. Am J Phys Med Rehabil. 2010 Aug. 89(8):660-7. [Medline].

  28. Karimi Mobarakeh M, Nemati A, Fazli A, Fallahi A, Safari S. Autologous blood injection for treatment of tennis elbow. Trauma Mon. 2013 Winter. 17(4):393-5. [Medline]. [Full Text].

  29. Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. 2006 Nov. 34(11):1774-8. [Medline].

  30. Creaney L, Wallace A, Curtis M, Connell D. Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: a prospective, single-blind, randomised trial of autologous blood injections versus platelet-rich plasma injections. Br J Sports Med. 2011 Sep. 45(12):966-71. [Medline].

  31. Raeissadat SA, Sedighipour L, Rayegani SM, Bahrami MH, Bayat M, Rahimi R. Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial. Pain Res Treat. 2014. 2014:191525. [Medline]. [Full Text].

  32. Krogh TP, Fredberg U, Stengaard-Pedersen K, Christensen R, Jensen P, Ellingsen T. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: a randomized, double-blind, placebo-controlled trial. Am J Sports Med. 2013 Mar. 41(3):625-35. [Medline].

  33. Mishra AK, Skrepnik NV, Edwards SG, Jones GL, Sampson S, Vermillion DA, et al. Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sports Med. 2014 Feb. 42(2):463-71. [Medline].

  34. Petrella RJ, Cogliano A, Decaria J, Mohamed N, Lee R. Management of Tennis Elbow with sodium hyaluronate periarticular injections. Sports Med Arthrosc Rehabil Ther Technol. 2010 Feb 2. 2:4. [Medline]. [Full Text].

  35. Zeisig E, Fahlström M, Ohberg L, Alfredson H. Pain relief after intratendinous injections in patients with tennis elbow: results of a randomised study. Br J Sports Med. 2008 Apr. 42(4):267-71. [Medline].

  36. Wong SM, Hui AC, Tong PY, et al. Treatment of lateral epicondylitis with botulinum toxin: a randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2005 Dec 6. 143(11):793-7. [Medline]. [Full Text].

  37. Placzek R, Drescher W, Deuretzbacher G, Hempfing A, Meiss AL. Treatment of chronic radial epicondylitis with botulinum toxin A. A double-blind, placebo-controlled, randomized multicenter study. J Bone Joint Surg Am. 2007 Feb. 89(2):255-60. [Medline].

  38. Hayton MJ, Santini AJ, Hughes PJ, et al. Botulinum toxin injection in the treatment of tennis elbow. A double-blind, randomized, controlled, pilot study. J Bone Joint Surg Am. 2005 Mar. 87(3):503-7. [Medline].

  39. Paoloni JA, Appleyard RC, Nelson J, Murrell GA. Topical nitric oxide application in the treatment of chronic extensor tendinosis at the elbow: a randomized, double-blinded, placebo-controlled clinical trial. Am J Sports Med. 2003 Nov-Dec. 31(6):915-20. [Medline].

  40. Brosseau L, Casimiro L, Milne S, et al. Deep transverse friction massage for treating tendinitis. Cochrane Database Syst Rev. 2002. CD003528. [Medline].

  41. Baker CL Jr, Baker CL 3rd. Long-term follow-up of arthroscopic treatment of lateral epicondylitis. Am J Sports Med. 2008 Feb. 36(2):254-60. [Medline].

  42. Sanders TL Jr, Maradit Kremers H, Bryan AJ, Ransom JE, Smith J, Morrey BF. The epidemiology and health care burden of tennis elbow: a population-based study. Am J Sports Med. 2015 May. 43 (5):1066-71. [Medline].

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Representation of the relationships in arthroscopic release for lateral epicondylitis.
 
 
 
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