Ultrasound-Guided Cortisone Injections for Tennis Elbow: A Comprehensive Guide

 Tennis elbow, or lateral epicondylitis, is a common condition characterised by pain and tenderness on the outer part of the elbow. Despite its name, it can affect anyone — not just athletes — who engage in repetitive arm and wrist movements. At Alton Pain Clinic, we provide advanced diagnostic and therapeutic interventions, including ultrasound-guided cortisone injections, tailored to alleviate the discomfort associated with tennis elbow.

This detailed guide explores tennis elbow in depth, covering its anatomy, pathology, and treatment options, with a specific focus on the role of cortisone injections.

Understanding Tennis Elbow

Definition

Tennis elbow is a condition resulting from overuse or strain of the tendons that attach to the lateral epicondyle of the humerus. It often involves micro-tears or degeneration of the extensor carpi radialis brevis (ECRB) tendon.

Anatomy of the Elbow

Key Structures

  1. Bones
  • Humerus: The upper arm bone, which forms the elbow joint.
  • Radius: The forearm bone located on the thumb side.
  • Ulna: The forearm bone located on the pinky side.

2. Lateral Epicondyle

  • The bony prominence on the outer part of the humerus where tendons of the forearm muscles attach.

3. Muscles and Tendons

  • Extensor Carpi Radialis Brevis (ECRB): Most commonly affected in tennis elbow.
  • Other extensor muscles contribute to wrist and finger movements.

4. Nerves

  • The radial nerve supplies sensation and motor function to the forearm and hand.

5. Ligaments and Bursa

  • Stabilise and cushion the joint during movement.

Pathology of Tennis Elbow

Mechanism

Tennis elbow results from repetitive stress, leading to:

  • Microtrauma: Small tears in the tendons attached to the lateral epicondyle.
  • Tendinosis: Degenerative changes due to failed healing responses.
  • Inflammation: Though typically minimal, early stages may involve some inflammatory processes.

Causes

  1. Repetitive Strain
  • Common in activities that involve gripping, wrist extension, or lifting.
  • Includes sports like tennis and occupations such as carpentry or painting.

2. Overuse Injuries

  • Excessive or unaccustomed activity can strain the tendons.

3. Poor Technique

  • Incorrect sports techniques or ergonomics can increase stress on the elbow.

Symptoms of Tennis Elbow

  • Pain: Localised to the outer part of the elbow, often radiating down the forearm.
  • Tenderness: Around the lateral epicondyle.
  • Weak Grip Strength: Difficulty holding or lifting objects.
  • Stiffness: Especially in the morning or after periods of inactivity.

Diagnosis of Tennis Elbow

Clinical Examination

  • History: A detailed account of symptoms and activities leading to discomfort.
  • Palpation: Identification of tenderness at the lateral epicondyle.
  • Resistance Testing: Pain is often reproduced with resisted wrist extension.

Special Tests

  • Cozen’s Test: Assesses pain with wrist extension and radial deviation.
  • Mill’s Test: Evaluates pain during passive wrist flexion with the elbow extended.

Imaging

  • Ultrasound: Reveals tendon thickening, tears, or calcification.
  • MRI: Provides detailed imaging for severe or refractory cases.

Management of Tennis Elbow

Non-Surgical Options

  1. Activity Modification
  • Avoiding activities that exacerbate symptoms.

2. Physical Therapy

  • Stretching and strengthening exercises to restore function.

3. Orthotics

  • Forearm straps or braces to offload stress from the affected tendons.

4. Medications

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for temporary relief.

5. Ultrasound-Guided Cortisone Injections

  • Targeted therapy to reduce inflammation and alleviate pain.

Ultrasound-Guided Cortisone Injections at Alton Pain Clinic

Why Ultrasound Guidance?

Ultrasound guidance ensures precise delivery of the cortisone injection to the site of tendon injury, minimising risks and maximising effectiveness.

  • Precision: Visualises tendons, ensuring accurate placement.
  • Safety: Avoids nearby nerves and blood vessels.
  • Comfort: Enhances patient experience during the procedure.

How Cortisone Helps with Tennis Elbow

Cortisone is a corticosteroid that addresses the underlying inflammation and pain in tennis elbow.

Mechanism of Action

  1. Anti-Inflammatory Effects
  • Suppresses the release of inflammatory mediators, such as prostaglandins and cytokines.
  • Reduces swelling and irritation around the lateral epicondyle.

2. Pain Relief

  • Decreases nerve sensitivity in the affected area.

3. Improved Function

  • Alleviation of pain allows for better engagement in rehabilitation exercises.

Benefits of Cortisone Injections

  • Rapid Pain Relief: Reduces discomfort quickly in many cases.
  • Targeted Treatment: Delivered directly to the site of injury.
  • Minimally Invasive: Avoids the need for surgical intervention.
  • Enhances Rehabilitation: Facilitates physical therapy by reducing pain.

Why Choose Alton Pain Clinic?

  1. Expert Clinicians: Our specialists have extensive experience in managing musculoskeletal conditions.
  2. Advanced Technology: We use state-of-the-art ultrasound equipment for precise injections.
  3. Personalised Care: Treatment plans tailored to each patient’s unique needs.
  4. Comprehensive Support: From diagnosis to post-procedure care, we guide you every step of the way.

Post-Injection Care

  • Rest the arm for 24–48 hours after the injection.
  • Gradually resume activities as advised by your clinician.
  • Follow prescribed physical therapy exercises to enhance recovery.

Conclusion

Tennis elbow can significantly impact daily activities, but effective treatment options are available. Ultrasound-guided cortisone injections, as offered at Alton Pain Clinic, provide a targeted and minimally invasive solution for managing pain and inflammation associated with this condition. By addressing symptoms and enabling functional improvement, these injections can be a vital component of a comprehensive treatment plan.

If you’re experiencing symptoms of tennis elbow, contact Alton Pain Clinic to explore how we can help you regain comfort and mobility.

Comments

Post a Comment

Popular posts from this blog

Ultrasound-Guided Cortisone Injections for Iliopsoas Tendinopathy/Bursitis

Image
  Introduction Iliopsoas tendinopathy and iliopsoas bursitis are common causes of anterior hip pain, particularly in individuals who engage in repetitive hip flexion activities such as running, cycling, or dancing. These conditions can significantly impact mobility, causing discomfort during walking, climbing stairs, or even prolonged sitting. While conservative management often includes rest, physiotherapy, and anti-inflammatory medications, some individuals may experience persistent symptoms requiring targeted interventions.  Ultrasound-guided cortisone injections are an option for managing pain and inflammation associated with iliopsoas-related conditions. This blog explores the anatomy, pathology, symptoms, diagnosis, and treatment options for iliopsoas tendinopathy and bursitis, with a focus on the role of ultrasound-guided cortisone injections. Anatomy of the Iliopsoas Muscle and Bursa The iliopsoas is a deep muscle group consisting of the psoas major, psoas minor, a...
Read more

Ultrasound-Guided Cortisone Injections for Morton's Neuroma

Image
  Introduction Morton’s neuroma is a painful condition affecting the nerves in the forefoot , most commonly between the third and fourth toes. It occurs due to thickening or irritation of the interdigital nerve , leading to symptoms such as burning pain, numbness, and a sensation of walking on a pebble . This condition is often caused by repetitive stress, improper footwear, or biomechanical abnormalities . At Alton Pain Clinic , ultrasound-guided cortisone injections may be considered as a targeted approach for reducing inflammation and pain in Morton’s neuroma. This blog provides a detailed overview of Morton’s neuroma , including anatomy, pathology, causes, symptoms, diagnosis, and treatment options , with a focus on how cortisone injections work and their mechanism of action . Anatomy of the Foot and Morton’s Neuroma The foot is composed of bones, muscles, ligaments, and nerves that work together to provide support and mobility . Key Anatomical Structures Involved in M...
Read more

Ultrasound-Guided Cortisone Injections for Triangular Fibrocartilage Complex (TFCC)

Image
  The Triangular Fibrocartilage Complex (TFCC) plays a critical role in stabilising the wrist and enabling complex movements. Injuries or degeneration of the TFCC can lead to significant discomfort and functional limitations. At Alton Pain Clinic, we specialise in advanced treatments, including ultrasound-guided cortisone injections, to help manage conditions affecting the TFCC. This blog provides a comprehensive overview of TFCC, including its anatomy, pathology, and how cortisone injections may assist in symptom management. Introduction to the TFCC The TFCC is a network of cartilage and ligaments located on the ulnar side of the wrist, providing stability to the distal radioulnar joint (DRUJ) and acting as a cushion between the ulna and carpal bones. Damage to the TFCC, whether from trauma or degenerative changes, is a common cause of wrist pain. Anatomy of the TFCC The TFCC consists of several interconnected components: Articular Disc:  A fibrocartilaginous structure that c...
Read more