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Everything you need to know
Tennis elbow is a condition that causes pain around the outside of the elbow, which can also radiate down the arm to the wrist. This can be mild and only felt when using the elbow, to a constant burning pain that interferes with everything from washing, dressing and sleeping. In some instances, people can even lose the ability to fully extend their arm.
It’s called tennis elbow because the prevalence is high in people that play tennis. In reality, it occurs in any number of sports, and even in people that don’t play any sports.
If you do think you might have tennis elbow, it’s important to get a formal diagnosis. Without this, you won’t receive the targeted treatment needed to effectively resolve it.
In 90% of cases, tennis elbow is a self-limiting condition and if it does require treatment, it is most likely to be non-operative. Most patients we see in upper limb orthopaedics can be treated non-operatively with lifestyle modifications, pain management, and by seeing a proper accredited upper limb physiotherapist.
When considering surgery, it’s important to remember that while many patients receive successful results from this operation, every surgical procedure can carry potential risks. However, rest assured that the surgeon will discuss all available treatment options, to make sure that all non-operative options have been exhausted.
Before
You’ll first need to meet with an orthopaedic consultant, so that they can properly assess your symptoms.
Establishing a diagnosis involves taking a history and conducting an examination. This can involve scans, such as x-ray, ultrasound or MRI to find out the severity of the problem, as this will also determine how we treat someone.
Before your surgery, you will need to come into hospital for a pre-assessment, where we can check your fitness for surgery. This is a standard check and includes a physical exam, blood tests, heart, and lung function tests.
If you take any blood thinners—for example, warfarin or aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake from a week before surgery. Your doctor will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
During
You will receive anaesthesia before the surgery to help manage pain and keep you comfortable during the operation. Your consultant will discuss your options for anaesthesia, such as general anaesthesia or local anaesthesia, and help you choose the best option for your needs.
The surgeon begins with an incision near your lateral epicondyle, which is the bony bump on the outer side of the elbow. The size and location of the incision can vary depending on the specific tear, its location, and the surgical technique being used. Common incision types include:
- Arthroscopic approach: In this minimally invasive technique, several small incisions are made, and a tiny camera (arthroscope) is inserted to provide a view of the inside of the elbow joint. Surgical instruments are then inserted through additional small incisions to repair the tear.
- Open approach: In some cases, particularly for larger or more complex tears, a larger incision may be made to directly access and repair the torn tendons and muscles.
The surgeon then identifies and releases the damaged or inflamed tendon. This release can be done using various techniques, including open surgery or minimally invasive procedures like arthroscopy. Once complete, the team then stitch the incision up and take you to the recovery centre.
After
Once general anaesthesia has worn off you should be dispatched home the day of your procedure. As you won’t be able to drive, make sure you’ve got someone to help you get back home safely.
After tennis elbow surgery, it’s likely that you’ll have some difficulty with normal activities for a little while. It’s important that you take recovery time seriously. Following the surgery, physical therapy and rehabilitation are essential for a successful recovery. You’ll have your arm in a sling for about two weeks after the operation for social protection, and an upper limb physiotherapist will work with you to gradually regain elbow strength and range of motion. The rehabilitation process can take from three to six months, and it’s crucial to follow the therapist’s guidance and any postoperative instructions provided by your surgeon.
Medically reviewed by Mr Abbas Rashid - BSc(Hons) MBBS FRCS(Tr&Orth) on 02/02/2024
How to pay for your treatment
If you’re… paying for yourself
Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.
For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.
If you’re… insured
St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.