Lateral Epicondylitis

Overview

Definition

Lateral epicondylitis is pain over the lateral epicondyle bone on the outside of the elbow. Another name for it is tennis elbow.

Lateral Epicondylitis
Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

Causes

Tendons connect muscles to bone. Repetitive or stressful movements of the muscles causes strain and pain at the tendon. The forearm muscles are active when a person grips something, such as a tennis racquet. Doing this repeatedly can cause pain at the tendon. Other things that may cause this problem are:

  • Hitting a tennis ball incorrectly
  • Using the wrong size tennis racquet or the wrong tension of racquet strings
  • Gripping or swinging a golf club the wrong way
  • Doing certain arm motions too much, such as:
    • Tennis strokes
    • Golf swings
    • Painting
    • Raking
    • Pitching
    • Rowing
    • Using a hammer or screwdriver

Risk Factors

This problem is more common in older adults. Other things that may raise the risk are:

  • Playing tennis or golf
  • Jobs that use repetitive wrist extension and gripping with a closed fist
  • Muscle imbalance
  • Lack of flexibility

SymptomsandDiagnosis

Symptoms

Symptoms happen slowly over time and may be:

  • Pain and tenderness on the outside of the elbow
  • Pain that may go down the forearm
  • Tight forearm muscles
  • Stiffness or trouble moving the elbow or wrist
  • Not being able to fully extend the elbow

Pain may be worse when:

  • Shaking hands
  • Turning doorknobs
  • Picking up objects with the palm down
  • Hitting a backhand in tennis
  • Swinging a golf club
  • Pressing on the outside of the elbow

Diagnosis

The doctor will ask about your symptoms and health history. You may also be asked about your recent physical activity. A physical exam will be done. It will focus on the elbow.

Images are not usually needed, but they may be done with:

  • X-rays
  • MRI scan

Treatments

Treatment

The goal of treatment is to ease pain and help with healing. Choices are:

  • Supportive care, such as cold compresses and avoiding activities that cause pain
  • Physical therapy to help with strength, flexibility, and range of motion
  • Wearing a forearm brace to limit movement during healing
  • Medicines, such as:
    • Over the counter pain relievers
    • Corticosteroid injections to ease pain and swelling

Prevention

To lower the risk of this problem:

  • Slowly increase the intensity and duration of activity
  • Use the right techniques and equipment for sports and activities
  • Exercise regularly to keep arm muscles strong

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Tennis Elbow)

RESOURCES

Ortho Info— American Academy of Orthopaedic Surgeons http://orthoinfo.org 

Sports Med—American Orthopaedic Society for Sports Medicine http://www.sportsmed.org 

CANADIAN RESOURCES

Canadian Association of General Surgeons http://www.cags-accg.ca 

Canadian Orthopaedic Foundation http://www.canorth.org 

References

Lai WC, Erickson BJ, et al. Chronic lateral epicondylitis: challenges and solutions. Open Access J Sports Med. 2018;9;243-251.

Lateral elbow tendinopathy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lateral-elbow-tendinopathy. Accessed January 28, 2021.

Tennis elbow (lateral epicondylitis). Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/tennis-elbow-lateral-epicondylitis. Accessed January 28, 2021.