Epicondylitis

Epicondylitis is more common in the dominant arm and has been attributed to overexertion with repetitive wrist and forearm use. Lateral epicondylitis is ten times more common than medial epicondylitis. It is thought to occur due to repetitive microtrauma and healing attempts within the origin of the forearm tendons.

The most consistent symptom is pain over the lateral (outside) or medial (inside) aspect of the elbow. This pain is usually sharp and exacerbated by activities involving wrist movement. Although there is often a history of repetitive activity, onset is frequently insidious with no clear inciting event.

If it is suspected that you may be suffering from epicondylitis, Dr Chia will perform a physical examination of the elbow in addition to xrays. In certain cases an MRI or ultrasound is needed to confirm the injury and rule out any other causes of elbow pain. Initial treatment consists of controlling the pain with rest, activity modification, bracing, simple analgesics and anti-inflammatory medications. A corticosteroid or PRP (Platelet rich plasma) injection may be helpful. Specific exercises are helpful for strengthening the muscles of the forearm and are best performed under the supervision of a therapist. Extracorporeal shock wave therapy may also help. Ensuring proper fit of equipment such as racquet grips is important.

The need for surgical management of epicondylitis rare. The most common approach is open surgery but ‘key-hole’ (arthroscopic) surgery is becoming more popular and involves debridement of the degenerative tendon.