This information will help you understand your choices, whether you share
in the decision-making process or rely on your doctor's recommendation.
Key points in making your decision
Surgery is
considered a last resort for treating
tennis elbow. But if you still have elbow and forearm
pain and stiffness after more than 6 to 12 months of non-surgical treatment
(rest, ice, rehabilitation), you may consider surgical treatment. When making
your decision, keep in mind:
Resting the
tendon is important. A typical case of tennis elbow
takes 6 to 12 months to heal. In some cases, the pain lasts for 2 years or
longer.1 With tendon rest and rehabilitation and
(possibly) 1 to 3 corticosteroid shots, most people with tennis elbow heal
within a year.
Tennis elbow tendon damage gets worse when you
continue painful, aggravating activity.
There are various surgical
procedures for treating tennis elbow. But there is no evidence to support any
one technique as being most effective or to prove that surgery is better than
other treatment.2
“Tennis elbow,” also called
lateral epicondylitis, is a term that describes soreness or pain on the outside
(lateral) part of the elbow. Tennis elbow symptoms occur when there is damage
to the end of the
tendon that connects lower-arm and hand muscles to the
upper arm bone at the elbow.
Tennis elbow is usually caused by repeated twisting
movements of the hand, wrist, or forearm done during everyday activities, such
as using a screwdriver or scissors, gardening, and various sports.
What kind of surgery is done for tennis elbow?
Your doctor may recommend an
arthroscopic exam of your outer elbow area, with a
plan to do surgery if necessary. Types of tennis elbow surgery are:
Removal of scar tissue from the damaged
tendon area.
Release (cutting) of the tendon that attaches the
extensor carpi radialis brevis (ECRB) muscle to the bone. The ECRB attachment
is thought to be the most common site of tennis elbow damage.
Repairing (reattaching) tendon tears if it's
possible to do it without overtightening the tendon.
Surgical
tendon repair is a reasonable treatment when there are large tears in the
tendon from a sudden (acute) injury or if there is other severe damage to the
elbow.
Surgery may be a reasonable treatment for tennis elbow if
you:
Have elbow pain after more than 6 to 12
months of tendon rest and rehabilitation.
Cannot do normal
daily-living and job-related activities because of elbow pain.
Have
had corticosteroid shots and still have elbow pain.
If you need more information, see the topic
Tennis Elbow.
Surgery may help some people who
still have pain after several months of other treatment. But there is not
strong evidence that it is better than other treatment for most
people.
Tennis elbow surgery research isn't complete enough to
recommend or discourage particular surgical procedures.
Your doctor is not certain of the cause of
your symptoms.
Your opposite elbow did not respond well to
surgery.
You have another medical condition, such as heart, lung,
or kidney disease, that may increase the risks of surgery or
general or regional anesthesia.
Are there other reasons you might not want to have
surgery?
Use this worksheet to help you make your decision.
After completing it, you should have a better idea of how you feel about
surgery for tennis elbow. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
I have used tendon rest and rehabilitation
measures for 6 to 12 months.
Yes
No
Unsure
My doctor is absolutely sure that I
have tennis elbow.
Yes
No
Unsure
My daily-living activities are painful.
Yes
No
NA*
My work activities are painful.
Yes
No
NA
My sports activities are painful.
Yes
No
NA
I am concerned that the tendon is becoming more
damaged over time.
Yes
No
Unsure
I am willing to stick to a rehabilitation program
after surgery.
Yes
No
Unsure
*NA = Not applicable
Use the following space to list any other important concerns you have
about this decision.
What is your overall impression?
Your answers in
the above worksheet are meant to give you a general idea of where you stand on
this decision. You may have one overriding reason to have or not have
surgery.
Check the box below that represents your overall
impression about your decision.
Leaning toward having surgery for tennis elbow
Leaning toward NOT having surgery for tennis elbow
Smidt N, et al. (2002). Corticosteroid injections,
physiotherapy, or a wait-and-see policy for lateral epicondylitis: A randomised
controlled trial. Lancet, 359(9307):
657–662.
Buchbinder R, et al. (2002). Surgery for lateral elbow
pain. Cochrane Database of Systematic Reviews (1).
Oxford: Update Software.
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
