Conservative Treatments

The most conservative method to treat Lateral Epicondylitis is through modalities (ice, heat), gentle stretching, immobilization of the wrist, counterforce bracing, activity modification, massage, and when appropriate gentle progressive eccentric strengthening of the wrist and hand.

Injections

Corticosteroid injections are the next step to address Lateral Epicondylitis and are commonly used in combination with therapy to help reduce inflammation and healing time of the common extensor tendon. The corticosteroid injections are very effective in reducing pain in the elbow, so it’s easy for forget that activity should be limited to ensure a proper recovery. Injections are used conservatively because if there are too many injections or if the amount is too much, it can cause weakening of the tendon and even necrotic tissue development of the bone and tendon.

Surgical Intervention

When surgery is determined by the doctor to be the best course of action, there are a few different approaches. The most conservative approach is when the surgeon simply removes the damaged aspect of the tendon to allow new tissue to develop in it’s place. A more in depth procedure is when the surgeon simply removes the tendon from the lateral epicondyle, debrides the necrotic tissue and bone, and reattaches the tendon to the lateral epicondyle. The next option is to simply remove the ECRB is simply released from the lateral epicondyle completely. Each procedure has a different protocol, so see the next page for more details on timelines and appropriate stretches!