Overview
Lateral epicondylitis, colloquially known as tennis elbow, occurs when the tendons in the elbow are overloaded. When overloaded, the tendon responsible for extending the wrist and fingers attaches to the bony bump located outside the elbow. The tendon involved is known as the Extensor Carpi Radialis Brevis, and irritation to this tendon causes pain and weakness in the forearm and wrist muscles that may radiate down the entire arm. Repetitive motion in the arms or wrists is the most common cause of tennis elbow.
While this form of tendinitis stems from tennis, this condition can affect anyone. Those engaging in racquet sports, fencing, weightlifting, typing, knitting, painting, and overusing tools such as chainsaws are at an increased risk of developing lateral epicondylitis. Normally, tennis elbow only affects one’s dominant arm, but it can occur in both arms. Those who are ambidextrous are at an increased risk for developing lateral epicondylitis in both arms.
Most cases of tennis elbow do not require medical attention, as rest paired with over-the-counter pain relievers and ice or heat therapy resolve most symptoms. Your physician may suggest using a forearm strap or brace during recreational activities that trigger pain.
Treatment options
Tennis elbow symptoms typically resolve themselves through rest. Other treatment options include:
- Lifestyle or career changes to reduce repetitive motions and ensure proper technique
- Physical therapy
- Medicine: over-the-counter pain relievers or topical creams, prescription pain medicine, or muscle relaxants
- Ice or heat therapy
- Strengthening exercises and stretching for arm muscles
- Functional mobility training
- Forearm strap or braces
- Acupuncture or dry needling
- Ultrasonic tenotomy: uses ultrasonic energy to liquefy damaged tissues and suctions them out
- Steroid, botox, or other irritant injections
- Surgery
Symptoms
- Pain in your elbow that may radiate into your forearm and wrist
- Weakness in wrist, forearm, or elbow
- Decreased grip strength
- Pain worsens when using forearm muscles
Diagnostic tests
Your healthcare provider will ask about the following information:
- The frequency, duration, and severity of your symptoms
- Your lifestyle habits and exercise regimen
- All medications you take, including over-the-counter medicine, supplements, vitamins, illicit drugs, or prescription medication
- Your medical history, including other medical conditions
- Any recent or past trauma to the elbow
- Familial history of similar symptoms
Your physician will conduct a physical examination, during which they will apply pressure to the affected area and evaluate your mobility and strength in your elbow, wrist, and fingers.
Your physician may order the following diagnostic tests to rule out other potential causes of your elbow pain:
- X-ray
- MRI
- CT scan
- Blood tests to rule out certain types of arthritis
- Electromyography to rule out nerve compression
Causes
- Overuse and muscle strain
- Repeated motions and stress
Risk factors for developing lateral epicondylitis include:
- Age
- Occupations that involve repetitive motions of the wrist and arm
- Playing racket sports
- Poor stroke technique in racket sports or occupation with repetitive motions
Facts
- Tennis elbow is more common among people aged 30 to 50
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