Tennis Elbow

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

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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

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

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