Lateral epicondylitis (tennis elbow)

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What is lateral epicondylitis?

Lateral epicondylitis, also known as tennis elbow, is an inflammation of the tendons that connect the forearm muscles on the outside of the elbow. Despite its nickname, lateral epicondylitis affects more than just tennis players. People who play a lot of racquet sports, or who perform activities that involve repeated gripping, are also at risk.

What causes lateral epicondylitis?

Lateral epicondylitis is an overuse injury caused by specific repetitive motions of the wrist and arm. The stress placed on the forearm by a tennis backstroke is a common culprit. It causes tiny tears to develop in one or more of the extensor tendons, which results in pain and inflammation in the elbow and arm.

In addition to tennis, lateral epicondylitis might result from racquetball, squash, fencing or weight lifting. It can also affect people who perform jobs that require repetitive arm movements or gripping, such as carpentry, painting or raking.

What are the symptoms?

Lateral epicondylitis typically causes pain and tenderness in the lateral epicondyle – the bony bump on the outside of the elbow where the tendons connect to the bone. Pain may also radiate along the forearm and wrist. Other symptoms include hand weakness when gripping or lifting and pain when making a fist or straightening your wrist.

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How is lateral epicondylitis diagnosed?

In addition to a complete physical exam and patient history, your doctor may order an X-ray, and sometimes an MRI, to confirm the diagnosis and rule out other damage to your hand, arm or neck. In certain cases, electromyography is used to rule out nerve compression in the elbow.

What is the treatment?

Most cases of lateral epicondylitis respond to non-operative treatment including rest, ice, anti-inflammatory medication and physical therapy. A wrist sprint or elbow strap may also help. If the pain persists, steroid injections or PRP therapy may provide relief. If these measures fail to alleviate your symptoms, surgery may be necessary. This involves releasing a portion of the tendon from the bone, removing the inflamed tendon or repairing tendon tears. Many procedures are performed arthroscopically with numerous benefits to the patient including less pain and blood loss, a very small incision, faster recovery, and a quicker return to work and activities.