Lateral Epicondylitis, popularly known as tennis elbow, is a fairly common condition associated with pain on the outside of the elbow where the extensor muscles of the forearm attach; It is caused by overuse or repetitive motions of the wrist and elbow. While it’s no surprise that playing tennis can be a major culprit in causing this condition, other activities can also cause lateral epicondylitis. The current golden standard surgical technique for tennis elbow, known as the Nirschl procedure, involves cutting away the damaged part of the tendon of the extensor carpi radialis brevis, which is a muscle in the forearm involved in wrist extension and elbow flexion.
A recently published randomized, double-blinded clinical study examined how effective the Nirschl procedure is for treating tennis elbow—improving pain, strength, and function—compared to a “sham” placebo surgery. The “sham” placebo surgery group simply had incisions sutured closed without removing damaged tissue. Researchers figured that there would be no major difference in outcome between the placebo group and the gold standard surgery group and the results of the study supported this hypothesis. Both groups showed comparable improvements in pain, strength, and function.
However, a major limitation of this study is that there were only thirteen participants in each group (a total of twenty-six patients in the study). Therefore, a broader trial with more subjects is needed to validate the results of this study. We generally recommend trying evidence based conservative options like PT Shockwave therapy and PRP, Platelet Rich Plasma or percutaneous needle tenotomy/TENEX before considering surgical intervention.
