I have a job as a glorified administrative assistant, which means I file and type all day. I've been struggling with a bad case of tennis elbow -- just can't seem to shake it. If I have surgery and it doesn't work, I'm afraid I'll lose my job. But if it gets much worse, I won't be able to do my job then either. What do other people do in these kinds of situations?

Lateral epicondylitis, commonly known as tennis elbow, causes pain that starts on the outside bump of the elbow, the lateral epicondyle. As you have discoverred, this condition is not limited to tennis players. Many other types of repetitive activities can also lead to tennis elbow including typing and filing. Just the act of pinching the fingers around the top of a file folder and pulling it up out of a file drawer over and over can lead to pain and dysfunction. Any activities that repeatedly stress the same forearm muscles can cause symptoms of tennis elbow. Rest and activity modification are the first two suggestions made for recovery from tennis elbow. But if you have a job that isn't easily modified, then you may need some additional help. A physical therapist can show you some exercises to help reduce the stress and tension on the tendons as well as some alternate ways to use the hands whenever possible. This can help save wear and tear on the soft tissues around the elbow. Some specific stretching and strengthening exercises may prove to be just what you need. If that doesn't help, your doctor can inject the area with cortisone, an antinflammatory to aid in pain relief. Acupuncture has been used successfully by some patients. A combination of physical therapy, massage, and acupuncture may be even better. But if all else fails and it's been months and months without pain relief, then some patients benefit from surgery. There are many ways to surgically approach this problem. Sometimes the surgeon just smooths away any frayed edges of tendon, shaves off any bone spurs, or possibly releases one or more tendons from around the elbow. The tendon retracts a short distance away from the bone and reattaches to nearby soft tissues. By taking the pressure off the bone, painful symptoms can be relieved without losing function.

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