Tennis Elbow, Lateral Epicondylitis

Dr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.

When the muscles responsible for extending the wrist and fingers become injured or damaged, it’s likely that the point of irritation is along the outer area of the elbow called the lateral epicondyle. This is the bony bump at which the muscle tissues of the forearm attach. Often called tennis elbow, the medical term for this muscle injury is lateral epicondylitis.

Symptoms associated with tennis elbow vary from person to person and may include pain during gripping activities or when muscles are stretched. In some cases, individuals experience discomfort when attempting to extend their wrist or fingers. Surprisingly, there is not always pain when moving the elbow or directly over the bony epicondyle, though tenderness is a common complaint. Even so, other symptoms may include neck stiffness and soreness along with nerve irritation.

It’s necessary to consider the similarities associated with both tennis elbow and neck pain or discomfort. This is because many individuals believe that they are suffering from lateral epicondylitis, when in fact their symptoms are referred pain from a cervical neck condition. Specifically, the C5 and C6 segments in the cervical region transmit pain signals along the radial nerve. If the nerve is damaged, having impaired neural mobility, symptoms are closely similar to those of tennis elbow.

Do tennis players suffer from tennis elbow? Yes (hence the name). Approximately 40% of all tennis players experience signs and symptoms of tennis elbow. While the average age of tennis elbow sufferers is between 35-50, it can affect anyone at any age, especially those who perform repetitive movements.

Treatment and Rehabilitation for Tennis Elbow, Lateral Epicondylitis

Because tennis elbow is a condition with a high rate of recurrence, patients receiving comprehensive treatment and rehabilitation have the greatest long-term success in terms of pain management and mobility.

Physiatrists are well-positioned to identify, propose and manage treatment for tennis elbow. Physiatrists consider multiple factors outside of a patient’s physical condition, including environment, lifestyle, training regimen and work habits. By doing so, they are given a window into daily activities and movements that may contribute to the patient’s pain or injury. This information becomes an important part of short and long-term pain management, as well as injury prevention.

Under the direction of the physiatrist, a team of medical professionals (physical, occupational therapists, clinicians and interventionists) initiate early treatment aimed at reducing the patient’s elbow pain. This is accomplished through a variety of conservative, tried and true techniques including rest, ice/heat therapy, ultrasound, electrical stimulation or bracing/splinting. Though not a cure-all, cortisone injections are administered to reduce symptoms in some cases.

Once pain is managed, selective rehabilitation to restore normal joint range of motion begins. With this rehabilitation, there is consideration of muscle length, strength and movement tendencies. Tennis elbow is known to cause some form of neural tension, so accurate assessment and treatment to the precise structure impeding the nerve must be administered. To better understand, imagine that a nerve is located next to an unstable joint. Since the joint is not functioning properly, the nearby nerve is obstructed. Blood flow, scar tissue and inflammation also adversely affect neural function, causing pain. As the upper limb neurodynamics are analyzed, a thorough assessment into cervical joint function is also important. As physiatrists obtain information from these and other assessments, rehabilitation is continuously tailored to the patient’s condition.

At the Howard Liss, M.D. Rehabilitation Institute in Englewood, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.

To schedule your appointment, contact the Howard Liss, M.D. Rehabilitation Institute today.

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