Tennis elbow

Tennis elbow, or lateral epicondylitis, is one of the most common elbow problems. It may be caused by a sudden injury or by repetitive use of the wrist and hand. The tendons that connect to the muscles that extend the wrist and fingers may degenerate and tear, resulting in pain along the outer side of the elbow. The pain is usually worse with gripping objects or with extending the wrist.  While the condition may occur in tennis players, particularly with a back hand stroke, tennis elbow can also occur in golfers and other athletes as well as in workers exposed to repetitive motion of the wrist and hand.

Most cases of tennis elbow can be successfully treated with rest, bracing, ice, anti-inflammatory medication and corticosteroid injection.  Recovery can be slow and recurrence may occur.  When symptoms do not respond to conservative management, surgery is performed.  Through a small incision, degenerated tendon tissue is debrided (cleaned out) and the underlying bone is drilled to create bleeding which is necessary for tendon repair. Most patients achieve pain relief and are able to return to sports participation in 3 months.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common source of hand numbness and pain. The tendons in the wrist swell and put pressure on the median nerve, one of three major nerves responsible for supplying feeling in the hand. It is more common in women than men and affects up to 10 percent of the entire population.

Surgery is done on an outpatient basis under local or regional anesthesia. During surgery, an incision is made in the palm. The roof of the carpal tunnel is divided to increase the size of the carpal tunnel and decrease pressure on the median nerve. Most patients see their symptoms improve after surgery, but recovery may be gradual.

Trigger Finger

Trigger finger, or flexor tenosynovitis, is a condition in which the tendons that flex the fingers become swollen and inflamed.  This results in pain at the base of one or more of the fingers. Locking or triggering of the finger frequently occurs as the swollen tendon tries to slide through the narrow tunnel that begins where the finger attaches to the palm of the hand.

Symptoms frequently respond to corticosteroid injection.  When they do not, outpatient surgery is very effective in relieving these symptoms.  Under local anesthesia, a ½ inch incision is created to access the tendon and its tunnel.  The entrance to the tunnel is divided, relieving pressure on the tendon, eliminating pain and locking.