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Lateral Epicondylitis
(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.
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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
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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:
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
RESOURCES
Ortho Info—
American Academy of Orthopaedic Surgeons
http://orthoinfo.org
http://orthoinfo.org
Sports Med—American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org
http://www.sportsmed.org
CANADIAN RESOURCES
Canadian Association of General Surgeons
http://www.cags-accg.ca
http://www.cags-accg.ca
Canadian Orthopaedic Foundation
http://www.canorth.org
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.
Revision Information
- Reviewer: EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
- Review Date: 12/2020
- Update Date: 02/01/2021
