Q: I have had tennis elbow for the better part of one year. I am not sure if I hurt it playing tennis or working out with weights. I have tried to rest it, take an anti-inflam-matory medication, done physical therapy, and had two cortisone shots.

When I rest it and do nothing it feels better but as soon as I try and play tennis or work out, the pain just comes back. I am very frustrated and my doctor says the next step is surgery to fix it.

Are there alternatives to surgery and is surgery successful if necessary?

A: Tennis elbow is usually caused by chronic repetitive stresses where the wrist extensor tendon originates on the outside part of the elbow. It sounds like your physician has done the usual things that will get approximately 95 percent of patients better with nonsurgical treatment.

Occasionally, where the tendon ``extensor carpi radialis brevis'' originates on the bone has a poor microcirculation that prevents adequate healing of the partially torn tendon. Another nonsurgical option that could be tried is OssaTron, a high-energy shockwave therapy. Recent studies have shown that patients that have failed all other nonsurgical modalities have a 70 percent cure rate with one treatment. However, after the treatment, a period of two to three months is necessary to know whether the tendon injury has healed completely.

In some patients for whom all other treatment modalities have failed, surgery is usually effective in significantly decreasing the symptomatology in approximately 95 percent of the cases.

Dr. Harlan Selesnick is in private practice in orthopedic surgery and sports medicine at Doctors Hospital in Coral Gables, and serves as team physician for the Miami Heat and Miami Dade College, among others. The Jock Doc column runs every other week.

Join the discussion

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. In order to post comments, you must be a registered user of MiamiHerald.com. Your username will show along with the comments you post. Thank you for taking the time to offer your thoughts.

     Showing: Oldest first Newest first Most-recommended first Least-recommended first

@Nyx.AuthorDisplayName@ wrote on @Nyx.PostedAtTime@:

@Nyx.repliedToText@

@Nyx.replyAnswerText@

Reply to this Comment @Nyx.Recommender@ @Nyx.AbuseReporter@