DEAR DR. ROACH: I’m a 75-year-old man who is quite active in many sports, including tennis. About six weeks ago, I developed pain in the outside of my elbow, which the internet tells me is lateral epicondylitis. I’ve never had an injury, including fractures, that is so persistent. I seem to be no closer to resuming my sports activities. Could you write about the condition and what treatments have the best chance of success? — R.R.
ANSWER: Lateral epicondylitis (“tennis elbow”) is a common cause of elbow pain, especially in athletes, so the internet might be right. However, there are at least a dozen other conditions that can mimic lateral epicondylitis, so I recommend a visit to your friendly physician to be sure. Sometimes an ultrasound or X-ray is necessary to rule out other possibilities; other times, a history and exam is enough to be pretty sure of the diagnosis.
If your doctor agrees with your diagnosis, the treatment regimen has several parts. The first is to stop the activity causing the problem in the first place. Often, improper body mechanics (or in tennis, an unsuitable racquet) cause the inflammation, and changing your movement will help prevent the problem. In any event, you’ll need to stop or slow down for some weeks. If you do keep up the activity, icing afterward will help.
Second, get a counterforce brace, which is pretty effective. You can buy one at your local pharmacy or online. Anti-inflammatories like ibuprofen are helpful. Finally, physical therapy for mobility and strengthening complete the initial treatment, and this regimen is effective for most people. If not, it’s time to reconsider the diagnosis, and perhaps get some additional testing or visit an expert, such as a sports medicine physician.
