Speaker: Manage patient expectations in treatment of lateral epicondylitis

ByKristine Houck, MA, ELS

Fact checked byGina Brockenbrough, MA

Key takeaways:

Steroid injections are not going to change the natural history of lateral epicondylitis.
Yao and colleagues reported more than 90% of patients achieve symptom resolution in 12 to 18 months.

KOLOA, Hawaii — Patients with lateral epicondylitis often present with pain and dysfunction, however, most of the time, symptoms get better on own, according to a presenter here.

“The patient will get better. If you want to do surgery and that’s what your patient wants, they’re going to get better. If you don’t want to do surgery and do an injection, they’re going to get better,” Rachel M. Frank, MD, said at Orthopedics Today Hawaii.

Elbow_Pain — Patients with lateral epicondylitis often present with pain and dysfunction, but symptoms may improve without intervention. *Image: Adobe Stock*

Lateral epicondylitis is a disruption of normal-ordered tendon fibers due to the invasion of fibroblasts and vascular granulation tissue.

Rachel M. Frank

“It’s actually a dysplastic change, a pathologic change, as opposed to an inflammatory change,” Frank said.

Frank said the task for orthopedic surgeons when treating patients with lateral epicondylitis, like many other chronic injuries frequently treated nonoperatively, is to help manage patient expectations. Steroid injections are not going to change anything in terms of the natural history of lateral epicondylitis, she said, but will make patients feel better temporarily.

Frank said a recently published study by Yao and colleagues reported that more than 90% of patients achieve symptom resolution in 12 to 18 months.

“They all get better eventually, and none of the injections change the natural history of this disease process within a short period of time. [The injections] may help get you from a 9-month process to a 6-month process, but nothing’s going to help get you from a 9-month process to a 2-day process, which is really what the patient wants,” Frank said.

Reference:

Yao L, et al. Arthroscopy. 2024; doi:10.1016/j.arthro.2024.11.070.

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Sources/Disclosures

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Source:

Frank RM. Update on tennis elbow: Injections, surgery or leave it alone. Presented at: Orthopedics Today Hawaii; Jan. 12-16, 2025; Koloa, Hawaii.

Disclosures: Frank reports being a paid consultant and speaker for AlloSource , Arthrex and JRF; receiving research support from Arthrex and Smith & Nephew; being a paid speaker for Ossur; and receiving publishing royalties, financial or material support from Elsevier.

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Speaker: Manage patient expectations in treatment of lateral epicondylitis

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