Causes and symptoms of epicondylitis
Epicondylitis, often referred to as tennis elbow or golfer’s elbow, is a painful inflammation of the tendon attachments at the elbow. It frequently affects people who perform repetitive movements or are exposed to heavy strain.
How epicondylitis develops
Epicondylitis is caused by overuse of the tendon attachments at the elbow. Frequently repeated movements, such as those that occur in certain sports or occupational activities, can cause micro-injuries to the tendons. These micro-injuries lead to inflammation and pain.
- Overuse: frequently repeated movements
- Sporting activities: tennis, golf, weightlifting
- Occupational activities: manual trades, office work
- Incorrect technique: unfavourable movement patterns
Other factors such as biomechanical imbalances, muscle tension or degenerative changes can also contribute to the development of epicondylitis. Timely diagnosis and treatment are crucial in order to avoid chronic complaints.
Typical symptoms of the condition
The symptoms of epicondylitis usually manifest themselves as pain and restricted movement in the elbow area. These symptoms can vary depending on the severity of the inflammation.
- Pain: localised pain on the outer or inner elbow
- Restricted movement: difficulty gripping or lifting objects
- Tenderness to pressure: sensitivity when touching the affected area
- Loss of strength: reduced grip strength and weakness in the forearm
Patients frequently report stabbing or burning pain that can radiate into the forearm. The complaints intensify during strenuous activities and subside during periods of rest. An early examination and treatment by an orthopaedic specialist in Munich is important in order to avoid long-term damage.
Further information on conservative treatment methods can be found in the section on conservative treatment methods.
Conservative treatment methods
The treatment of epicondylitis often begins with conservative methods. These measures aim to relieve the symptoms and promote healing before surgery for epicondylitis is considered.
Physiotherapy and rest
Physiotherapy and rest are crucial components in the conservative treatment of epicondylitis.
Physiotherapy
Physiotherapy can help to strengthen the muscles around the affected joint and improve flexibility. The aim is to reduce the strain on the inflamed area.
- Manual therapy: improving joint mobility; 30-60 minutes per session
- Ultrasound therapy: deep heat to reduce inflammation; 10-15 minutes per session
- Stretching exercises: increasing flexibility; 10-20 minutes daily
Rest
Reducing the strain is equally important. You should avoid activities that cause pain and give the affected arm sufficient rest.
Drug therapies
Drug therapies also play an important role in the conservative treatment of epicondylitis.
Painkillers and anti-inflammatory drugs
Painkillers and non-steroidal anti-inflammatory drugs (NSAIDs) can help to relieve pain and inflammation.
- NSAIDs (e.g. ibuprofen): anti-inflammatory action; every 4-6 hours
- Paracetamol: pain reduction; every 6-8 hours
Corticosteroid injections
In some cases, corticosteroid injections can be administered directly into the affected area. These injections can relieve inflammation and pain in the short term.
- Corticosteroid injection: reduction of local inflammation; every 3-6 months
The choice of conservative treatment method depends on the severity of the symptoms and the patient’s response to the therapy. Further information on specific measures and the optimal approach can be found in our articles on tendon therapy and physical therapies.
Indications for surgery for epicondylitis
Various conservative therapies are available for the treatment of epicondylitis, also known as tennis elbow. In some cases, however, surgical treatment may become necessary in order to relieve the complaints permanently.
When is surgery necessary?
Surgery for epicondylitis is generally considered when conservative treatment methods have not brought about a satisfactory improvement of the complaints over a period of six to twelve months. The indications for surgery include:
- Persistent pain despite intensive physiotherapy measures and rest
- Insufficient relief of symptoms through drug therapies
- Restricted mobility and impairment of quality of life
- Recurring inflammation and swelling in the elbow area
In certain cases, patients can also benefit from surgery if there are specific anatomical problems that cannot be resolved by conservative measures. A careful examination and consultation with an orthopaedic specialist in Munich is essential in order to determine the appropriate treatment option.
Preparing for the surgical procedure
Thorough preparation is crucial for the success of surgery for epicondylitis. You should be prepared to go through a number of preparatory steps:
- Preliminary discussion with the surgeon: a detailed discussion of the planned procedure, the expected results and the possible risks and complications
- Medical tests: blood tests, X-rays and other diagnostic tests to determine your current state of health and to prepare for the operation. Further information on specific surgical procedures can be found in our article on elbow surgery.
- Preparation of the operating site: cleaning and, if necessary, shaving of the affected area in order to minimise the risk of infection
- Adjustment of medication: under certain circumstances, particular medicines such as blood thinners have to be discontinued a few days before the operation
- Preliminary discussion: discussion of the details of the procedure
- Medical tests: blood tests, X-rays
- Operating site: cleaning and shaving
- Medication: adjustment or discontinuation of certain medicines
Careful preparation for the surgical procedure contributes significantly to a successful outcome of the operation and a quick recovery. After the operation, consistent aftercare and physiotherapy are important in order to restore full function of the elbow and to avoid relapses.
Types of surgery for epicondylitis
If conservative methods are not sufficient, surgery for epicondylitis is considered in order to relieve long-lasting pain and restore the function of the elbow. Various surgical techniques and procedures are used here to achieve the best possible results. At the same time, patients need to be aware of the potential risks and complications.
Techniques and procedures
Various surgical techniques are used to treat epicondylitis. These vary depending on the severity of the condition and the individual needs of the patient.
Open surgery
In open surgery, a larger incision is made in order to allow direct access to the affected tendons and muscles. This method allows precise adjustment and repair of the affected tissue.
Arthroscopic surgery
Arthroscopic surgery is minimally invasive and uses small incisions and a camera to see inside the joint. This technique reduces the healing time and minimises scarring.
- Open surgery: advantages – direct access, precise repair; disadvantages – larger incision, longer healing
- Arthroscopic surgery: advantages – less invasive, shorter healing; disadvantages – limited visibility
For further information on surgical procedures, please visit our article on elbow surgery.
Risks and complications
As with all surgical procedures, there are certain risks and possible complications with surgery for epicondylitis as well. The most common include:
- Infections: despite sterile conditions, infections can occur.
- Scarring: particularly with open surgery, scar tissue can form that may restrict mobility.
- Nerve damage: there is a risk that surrounding nerves may be damaged, which can lead to numbness.
- Blood clots: post-operative thrombosis is a rare but serious complication.
Individual patient factors such as state of health and lifestyle can influence the risk of complications. Detailed consultation and preparation are essential here. For more information on the planning and preparation of operations, please visit our page on sports medicine consultation.
By carefully weighing up the benefits and risks of the various techniques, patients and doctors can together make the best possible decision for the treatment of epicondylitis.
Aftercare and rehabilitation
Follow-up care and physiotherapy
Follow-up care after surgery for epicondylitis is crucial for successful healing. In the first few days after the procedure, the affected arm is usually immobilised in order to support healing and reduce swelling. Targeted physiotherapy generally begins after a few days or weeks, depending on the course of healing and your doctor’s instructions.
Physiotherapy is a central part of rehabilitation, as it helps to restore mobility and strength in the affected arm. Common physiotherapy measures include:
- Mobilisation exercises: promote the mobility of the elbow.
- Strengthening exercises: strengthen the muscles around the elbow.
- Stretching exercises: improve the flexibility of the tendons and muscles.
An individual rehabilitation programme is drawn up by the physiotherapist and tailored to your needs.
- Weeks 1-2: immobilisation, light mobilisation exercises
- Weeks 3-4: start of strengthening exercises, stretching exercises
- From week 5: intensified physiotherapy, gradual return to everyday activities
Recommendations for a quick recovery
In order to promote a quick and successful recovery after surgery for epicondylitis, you should observe a few important recommendations:
- Regular physiotherapy: attending all recommended physiotherapy sessions is crucial.
- Rest and gradual loading: the affected arm should not be overloaded; a gradual increase in loading is advisable.
- Ice treatment: applying ice packs to reduce swelling and pain.
- Healthy diet: a balanced diet supports the healing processes in the body.
- Keeping medical appointments: regular check-ups with the doctor are important in order to monitor the progress of healing.
For further information on elbow surgery and related topics, please visit our articles on elbow surgery and calcific shoulder. Specific details on bursa removal at the elbow can also be useful.
With the right aftercare and structured rehabilitation, surgery for epicondylitis can offer a significant improvement in quality of life and in the function of the affected arm.
