The elbow joint links the upper arm bone (humerus) to the two forearm bones (radios and ulna). It enables us to bend, extend, rotate, and straighten the forearm (Dwyer, 2009). Whenever our arms need stability and support, our elbows allow precise and accurate movements. It is a pivotal joint for performing daily tasks like lifting, holding, and moving objects around us.
Your tendons connect your muscles to your bones. As you perform repetitive arm and wrist motions, this can result in overloaded elbow tendons. This leads to swelling, pain, and tenderness. This orthopaedic condition is called lateral epicondylitis or tennis elbow. In Singapore, treatment for tennis elbow pain includes surgical and nonsurgical methods, depending on your condition.
Tennis elbow, also known as lateral epicondylitis, is a condition that presents with pain over the outer part of the elbow joint. Despite its name, anyone can be diagnosed with tennis elbow. It is the most common cause of pain in the elbow region, as the pain frequently arises from muscle overuse from labour-intensive tasks.
A tendon, which looks like a thick cord, is a tissue that connects muscles to bones. When your forearm muscles are overused, it causes damage to the tendon (Alaia, 2020). Tennis elbow arises from degeneration from the extensor carpi radialis brevis (ECRB) tendon. This tendon is located in the outer portion of your forearm. The treatment of this condition is to promote healing of the injured tendon, by using whatever necessary combination of surgery, injections, medications, and physiotherapy.
(image source: https://www.news-medical.net/health/What-Causes-Tennis-Elbow.aspx)
Tennis elbow is typically caused by overuse of the forearm muscles over time. During manual labour such as cleaning or cooking, you may strain your muscles (Johns Hopkins Medicine, 2020). People can develop tennis elbow through:
If you often perform repetitive tasks that involve the forearms, wrists, or hands, you may be at risk for this condition. You may experience the following symptoms, which can worsen over time:
Tennis elbow symptoms can be similar to other health conditions. A consultation with your orthopaedic surgeon can help in properly diagnosing your specific ailment. The process may include:
(image source: https://www.gdosteopathy.co.uk/enfield/tennis-elbow/)
Surgical and Non-Surgical Treatment Options for Alleviating Tennis Elbow Pain
Tennis elbow pain can be attributed to many causes. Your orthopaedic surgeon will give you a treatment plan that will target the source of your pain (Johns Hopkins Medicine, 2020).
1.Surgical Treatments are usually the last resort for this condition, but it can be recommended for severe cases of tennis elbow.
2.Non-Surgical Treatments may also involve non-invasive or minimally invasive methods.
Tendon treatments have continued to develop throughout the years. Ultrasound guided tendon debridement is a new surgical procedure for early-stage tennis elbow cases. Debridement involves the removal of the damaged sections of tendons. The remaining healthy tendons are then sewn together (Masci et al., 2020).
(image source: https://www.csp.org.uk/conditions/elbow-pain)
Patients who underwent tennis elbow surgery may return to full activities 6 weeks to 2 months after the procedure. Most patients will regain full range of elbow motion within 2 weeks of surgery. Remember, treatment does not stop after the surgical procedure. You may be required to attend physiotherapy sessions as part of the recovery and rehabilitative plans (Cleveland Clinic, 2021).
Taking care of the elbow is important for joint health, continuous mobility, and injury prevention. It’s important to talk to an orthopaedic surgeon for effective diagnosis and treatment of elbow problems. They can give you personalised advice and treatment options for the best results and long-term health.
Tennis elbow, or lateral epicondylitis, is a condition caused by overuse or strain of the tendons in the elbow, leading to pain and discomfort.
Symptoms include pain and tenderness on the outer part of the elbow, difficulty gripping objects, and discomfort when twisting or lifting items.
There is no best treatment. It depends on the severity of the condition and may include rest, physical therapy, medications, or injections. Consult a specialist for personalised care.
Yes, over-the-counter pain relievers, anti-inflammatory drugs, and topical medications can help reduce pain and inflammation in mild cases.
Non-surgical options include physical therapy, braces, corticosteroid injections, shockwave therapy, and platelet-rich plasma (PRP) injections.
Surgery is considered when non-surgical treatments fail after 6–12 months. It involves removing damaged tissue and repairing the tendons.
Yes, braces or supports can reduce strain on the tendons, provide pain relief, and allow healing during daily activities.
Recovery time varies, but most patients see improvement within 6–12 weeks with appropriate treatment. Severe cases may take longer.
Yes, tennis elbow can recur if repetitive strain continues. Preventive measures, such as proper technique and strengthening exercises, are crucial.
Yes, tennis elbow can occur in anyone performing repetitive arm or wrist motions, such as typing, painting, or carpentry, not just athletes.
Seek medical advice if the pain persists for more than a few weeks, worsens, or interferes with daily activities despite self-care measures.
To make sure you get better after surgery for tennis elbow, you must do the exercises that the surgeon and trainer tell you to do. Also, it’s important to follow the suggested rehabilitation protocol because it’s a key part of healing and getting back to normal function.
Dr Yong Ren graduated from the National University of Singapore’s Medical faculty and embarked on his orthopaedic career soon after. Upon completion of his training locally, he served briefly as an orthopaedic trauma surgeon in Khoo Teck Puat hospital before embarking on sub-specialty training in Switzerland at the famed Inselspital in Bern.
He underwent sub-specialty training in pelvic and spinal surgery, and upon his return to Singapore served as head of the orthopaedic trauma team till 2019. He continues to serve as Visiting Consultant to Khoo Teck Puat Hospital.
Well versed in a variety of orthopaedic surgeries, he also served as a member of the country council for the local branch of the Arbeitsgemeinschaft für Osteosynthesefragen (Trauma) in Singapore. He was also involved in the training of many of the young doctors in Singapore and was appointed as an Assistant Professor by the Yong Loo Lin School of Medicine. Prior to his entry into the private sector, he also served as core faculty for orthopaedic resident training by the National Healthcare Group.
Dr Yong Ren brings to the table his years of experience as a teacher and trainer in orthopaedic surgery. With his expertise in minimally invasive fracture surgery, pelvic reconstructive surgery, hip and knee surgery as well as spinal surgery, he is uniquely equipped with the tools and expertise necessary to help you on your road to recovery.
Alaia, M. (2020). Tennis Elbow (Lateral Epicondylitis). Retrieved
https://orthoinfo.aaos.org/en/diseases–conditions/tennis-elbow-lateral-epicondylitis/
Cleveland Clinic. (2021). Tennis Elbow (Lateral Epicondylitis). Retrieved from
https://my.clevelandclinic.org/health/diseases/7049-tennis-elbow-lateral-epicondylitis
Dwyer, T. (2009). The Bone School. Retrieved from http://www.boneschool.com/
Johns Hopkins Medicine. (2020). Lateral Epicondylitis (Tennis Elbow). Retrieved from
https://www.hopkinsmedicine.org/health/conditions-and-diseases/lateral-epicondylitis-tennis-elbow
Masci, L., Alfredson, H., Neal, B., & Wynter Bee, W. (2020). Ultrasound-guided tendon
debridement improves pain, function and structure in persistent patellar tendinopathy: short term follow-up of a case series. BMJ open sport & exercise medicine, 6(1), e000803.
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