At Home with Dr Christian Jessen - 345

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MEET THE
EXPERT

Mr Mark Jeffery
MB BS FRCS
FRCS (Orth)
is a consultant
orthopaedic surgeon
Mr Jeffery works at Lewisham University
Hospital London. He is a specialist in
upper limb surgery serving patients
in London and Surrey.
He has also been appointed the
Royal College of Surgeon's Surgical
Tutor and the Educational Lead, where
he is responsible for teaching the
next generation of surgeons.

*Painkillers and paracetamol can help with

pain, and anti-inflammatory medication
helps with swelling as well as pain
*Braces and straps work by reducing the
forces going through the tendon in your
elbow and hence reducing pain
If your symptoms don't ease after a fortnight,
you should visit your doctor. A variety of tests
can then be used to confirm the diagnosis.

Further treatment

Joint venture
It isn't just sportspeople who have to deal with painful shoulder
and upper limb conditions; tennis elbow is a common complaint

T

ennis elbow (or lateral
epicondylitis), is a painful
condition of the elbow that
is caused by relative overuse
in the muscles and tendons on the
back of the forearm attaching to
the outside of the elbow, which lift
(extend) the wrist and fingers. The
pain is caused by severe inflammation
through repeated strain of one
particular tendon called the extensor
carpi radialis brevis.

Earning its name by excessive hitting
of tennis balls, contrary to general belief,
anybody can develop tennis elbow. This
overuse injury is linked with activities that
involves repeated stress on the elbow joint and
repetitive extension of the wrist and hand,
such as decorating or playing the violin,
carpenters and plasterers continually gripping,
or those involved with fine, repetitive hand
and wrist movements such as typing.

21100-104760 Mark Jeffery FP.indd 37

What are the symptoms?

They develop gradually, in most cases the pain
begins as mild and slowly worsens over weeks
and months. Rarely is a specific history of
injury associated. Commonly, you have:
*Pain on the outside of your upper forearm,
just below your elbow, the pain may travel
down your forearm towards your wrist
*Stiffness when fully extending your arm and
increased tenderness when pressure is
applied on the outside of your elbow
*Pain when lifting or bending your arm;
writing or gripping objects; or twisting your
forearm for example turning a door handle

*Physiotherapy, deep tissue massage and

acupuncture can be performed to reduce pain
and stiffness. Supervised exercises including
stretching and eccentric loading (active muscle
contraction) are often successful over time
*Steroid joint injection (cortisone) injected
directly into the painful area can provide
short-term relief (long-term relief is unpredictable)
*Extracorporeal shock wave therapy passes
sound waves to the elbow to promote the
body's natural healing processes
*Platelet Rich Plasma (PRP) injections use the
body's natural healing factors in order to
heal the affected tendon. These two treatments
are new and, as yet, unproven long term

When is surgery an option?

If symptoms persist, consider referral to a
specialist surgeon. Surgery is performed by a
surgical release procedure where the tendon is
released. The inflamed tissue is removed and
the tendon is released. Arthroscopic (keyhole)
surgery can be used in some cases.
After surgery, you will wear a splint, which
will be removed a week later along with the
sutures. Exercises are introduced to restore
flexibility and you can return to athletic activity
usually four to six months after surgery.

What can be done?

*Rest your arm and stop doing the activity
that's causing the problem

*Hold ice or a cold compress against your

elbow for a few minutes several times a day

*Putting a heat pack on your elbow can
help to ease your pain

FOR MORE INFORMATION
Call Mr Mark Jeffery's private secretary
on 020 8543 9924 or his
NHS secretary on 020 8333 3000
Email shoulderarmspecialist@gmail.com

27/01/2015 14:38
At Home with Dr Christian Jessen

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