Tennis Elbow and Arthroscopic Treatment
Tennis elbow is wear of the tendons on the outer side of the elbow from overuse. Most patients recover without surgery; arthroscopy is an option when symptoms persist.
Despite its name, tennis elbow (lateral epicondylitis) is seen more often in people who use their wrist and fingers repetitively than in tennis players. Computer work, hand tools, carrying, knitting and gardening can all cause it. The problem is micro-tearing and wear of the tendons attached to the bony point on the outer side of the elbow, especially the ECRB tendon.
Symptoms
- Pain on the outer side of the elbow, sometimes spreading into the forearm
- Pain that increases when gripping, lifting a cup or shaking hands
- Weaker grip
- Tenderness when pressing on the outer side of the elbow
Diagnosis
The diagnosis is usually made on examination. Lifting the wrist against resistance or pressing on the middle finger brings on the pain. Ultrasound or MRI may be used to assess the tendon and look for problems inside the joint. Conditions with similar pain, such as nerve compression from the neck, are ruled out.
Non-surgical treatment
Most people with tennis elbow recover without surgery, although it can take time.
- Reducing movements that trigger pain and adjusting work ergonomics
- Exercises that stretch and strengthen the forearm muscles, especially eccentric exercises
- A forearm strap (epicondylitis band)
- Physiotherapy and shockwave therapy
- PRP injection in suitable patients
Steroid injections can relieve pain in the short term, but repeated injections can weaken the tendon, so they are used with care.
Arthroscopic treatment
Surgery is considered when symptoms continue for 6-12 months despite regular non-surgical treatment. In arthroscopy, a camera is passed into the elbow through small holes; the damaged tendon tissue is cleaned and any other problems inside the joint (a synovial fold, cartilage damage) are treated in the same session. The small incisions aim to limit damage to the surrounding tissue. Open surgery may be preferred in some patients.
Recovery
After surgery, the elbow is protected briefly and movement exercises begin. The strengthening programme is progressed gradually. Returning to light work usually takes a few weeks, and heavy work and sport take a few months.
Small changes in daily life
Lifting objects with the palm facing up, keeping the wrist straight when using a keyboard and mouse, carrying heavy bags on the shoulder and taking frequent breaks during gripping tasks reduce the load on the tendons at the outer elbow. For tennis players, adjusting grip size and string tension can also help.
Frequently asked questions
Does tennis elbow go away on its own?
Symptoms ease within months in many patients. The right exercises and changes to straining activities speed up recovery.
Should I have a steroid injection?
Steroids can give short-term relief, but symptoms may return later and frequent injections can harm the tendon. The decision is made together after examination.
When can I return to work after surgery?
Desk work can usually be resumed within a few weeks. Jobs that need arm strength take longer.
What does a forearm strap do?
A strap worn on the upper forearm can spread the tension on the tendon and reduce pain. It is not a cure on its own and is used together with exercises.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.