Elbow Epicondylitis

Patients with elbow epicondylitis complain of pain either along the inner or outer aspect of the elbow which worsens with repetitive gripping or wrist motions. The pain may progress to the point where simple maneuvers such as twisting a doorknob or lifting a cup of coffee cause severe elbow pain. Patients can develop mild to moderate weakness in addition to the chronic pain. Elbow epicondylitis is best diagnosed by a physical examination by an orthopedist. An MRI (magnetic resonance imaging) may be obtained to confirm irritation or inflammation of the tendons stemming from the elbow.

Epicondylitis of the elbow is best treated at first with rest from vigorous activity, ice, anti-inflammatory medication (such as Motrin or Advil) and a formal physical therapy program for range of motion, stretching and strengthening. Next, a cortisone injection may help relieve inflammation and pain. If symptoms continue and seriously interfere with work, recreation and sleep, then surgery may be warranted. Elbow epicondylitis requires a 1 inch incision over either the inner or outer aspect of the elbow (depending on the site of inflammation.) The area of the tendon involved with the chronic inflammation is removed and the normal adjacent tendon is then reattached to its normal site on the bone. This procedure takes about 45 minutes and is done on an outpatient basis (without an overnight stay in the hospital).

A plaster splint is applied to the elbow at the time of the procedure and the arm is placed in a sling. Gentle finger range of motion is encouraged during the first week. The patient returns for a follow-up visit 7-10 days after surgery and the plaster splint and stitches are removed. At this point the patient starts a formal exercise program with a physical therapist. How long is the recovery after elbow epicondylitis surgery? Patients may return to work within 10-14 days. If their job requires heavy lifting, climbing or throwing then return may be delayed 8-12 weeks. The first 6 weeks of therapy focus on regaining full elbow range of motion; the second six weeks focus on restoring full strength to the elbow and forearm muscles. Full recovery and return to pre-injury athletic activities occurs within 3 months after elbow epicondylitis surgery.